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Boy, that's a pretty big " ouch " . While I sincerely hope no-one who was

resurfaced suffered any serious health problems otherwise not anticipated, I

imagine

this is exactly why US surgeons are terrified of recommending resurfacing.

Expect fallout.

Des Tuck, Esq.

In a message dated 5/25/2004 2:08:52 PM Pacific Standard Time,

ether25@... writes:

Did everyone see the warning letter to from the FDA today? Is

it the conserve +?

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Boy, that's a pretty big " ouch " . While I sincerely hope no-one who was

resurfaced suffered any serious health problems otherwise not anticipated, I

imagine

this is exactly why US surgeons are terrified of recommending resurfacing.

Expect fallout.

Des Tuck, Esq.

In a message dated 5/25/2004 2:08:52 PM Pacific Standard Time,

ether25@... writes:

Did everyone see the warning letter to from the FDA today? Is

it the conserve +?

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Boy, that's a pretty big " ouch " . While I sincerely hope no-one who was

resurfaced suffered any serious health problems otherwise not anticipated, I

imagine

this is exactly why US surgeons are terrified of recommending resurfacing.

Expect fallout.

Des Tuck, Esq.

In a message dated 5/25/2004 2:08:52 PM Pacific Standard Time,

ether25@... writes:

Did everyone see the warning letter to from the FDA today? Is

it the conserve +?

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This could be true as a practical matter, but people exposed to legal

liability tend to become overly paranoid and that's why I think it could turn

out to

be a bigger deal than it perhaps ought to be.

Des Tuck

(Wearing the lawyer's hat again)

In a message dated 5/25/2004 3:37:08 PM Pacific Standard Time, kbrews@...

writes:

In another forum some

people familiar with the industry said the letter was pretty much a

slap on the wrist to get to get their act together on this

study.

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This could be true as a practical matter, but people exposed to legal

liability tend to become overly paranoid and that's why I think it could turn

out to

be a bigger deal than it perhaps ought to be.

Des Tuck

(Wearing the lawyer's hat again)

In a message dated 5/25/2004 3:37:08 PM Pacific Standard Time, kbrews@...

writes:

In another forum some

people familiar with the industry said the letter was pretty much a

slap on the wrist to get to get their act together on this

study.

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Well, let's face it, Steve, there are other reasons why insurance companies

don't pay for things, and in my opinion you're being too kind. But this is a

dignified site and I won't express what I feel about them here.

Des

In a message dated 5/25/2004 4:38:14 PM Pacific Standard Time,

sog@... writes:

And why insurance companies are reluctant to pay for it, too

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Well, let's face it, Steve, there are other reasons why insurance companies

don't pay for things, and in my opinion you're being too kind. But this is a

dignified site and I won't express what I feel about them here.

Des

In a message dated 5/25/2004 4:38:14 PM Pacific Standard Time,

sog@... writes:

And why insurance companies are reluctant to pay for it, too

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> Did everyone see the warning letter to from the FDA today?

Is

> it the conserve +?

, I saw that, and based on some of the details in the letter, I

believe it to be about the Conserve Plus study (the name of the

device and some other details are blanked out for privacy).

I have not asked anyone at about this, but they are always mum

on FDA issues involving studies in progress. In another forum some

people familiar with the industry said the letter was pretty much a

slap on the wrist to get to get their act together on this

study. To me this is making it seem very unlikely that the Conserve

Plus will be approved this year. I am sorry to say that to those

suffering while waiting. will have to answer the questions

raised and work to increase the follow-up rate.

Some of the things cited were relatively trivial reporting errors,

the kind I imagine are easy to slip through the cracks when you are

dealing with several hundred patients across the country. However,

after the run-around the FDA gave them with the ceramic study and

approving their supplier you would think they'd be extra careful on

this PMA. There were no problems with the devices themselves failing

or anything of that nature.

They did cite a problem with missing follow-ups for a number of

patients. As with the Corin study mentioned recently, please

get your follow-ups done if you are behind on your one-year or two-

year anniversary!! I know its hard to do when you are enjoying

getting back into a pain-free life. Of course, we're probably

preaching to the choir in this forum.

-

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> Did everyone see the warning letter to from the FDA today?

Is

> it the conserve +?

, I saw that, and based on some of the details in the letter, I

believe it to be about the Conserve Plus study (the name of the

device and some other details are blanked out for privacy).

I have not asked anyone at about this, but they are always mum

on FDA issues involving studies in progress. In another forum some

people familiar with the industry said the letter was pretty much a

slap on the wrist to get to get their act together on this

study. To me this is making it seem very unlikely that the Conserve

Plus will be approved this year. I am sorry to say that to those

suffering while waiting. will have to answer the questions

raised and work to increase the follow-up rate.

Some of the things cited were relatively trivial reporting errors,

the kind I imagine are easy to slip through the cracks when you are

dealing with several hundred patients across the country. However,

after the run-around the FDA gave them with the ceramic study and

approving their supplier you would think they'd be extra careful on

this PMA. There were no problems with the devices themselves failing

or anything of that nature.

They did cite a problem with missing follow-ups for a number of

patients. As with the Corin study mentioned recently, please

get your follow-ups done if you are behind on your one-year or two-

year anniversary!! I know its hard to do when you are enjoying

getting back into a pain-free life. Of course, we're probably

preaching to the choir in this forum.

-

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> Boy, that's a pretty big " ouch " . While I sincerely hope no-one who was

> resurfaced suffered any serious health problems otherwise not

anticipated, I imagine

> this is exactly why US surgeons are terrified of recommending

resurfacing.

And why insurance companies are reluctant to pay for it, too.

> Expect fallout.

I'm really glad I didn't wait any longer.

Steve (bilat C+ 4/20/04, Amstutz)

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> Boy, that's a pretty big " ouch " . While I sincerely hope no-one who was

> resurfaced suffered any serious health problems otherwise not

anticipated, I imagine

> this is exactly why US surgeons are terrified of recommending

resurfacing.

And why insurance companies are reluctant to pay for it, too.

> Expect fallout.

I'm really glad I didn't wait any longer.

Steve (bilat C+ 4/20/04, Amstutz)

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Guest guest

> > Did everyone see the warning letter to from the FDA

today?

> Is

> > it the conserve +?

>

> , I saw that, and based on some of the details in the letter, I

> believe it to be about the Conserve Plus study (the name of the

> device and some other details are blanked out for privacy).

>

> I have not asked anyone at about this, but they are always

mum

> on FDA issues involving studies in progress. In another forum some

> people familiar with the industry said the letter was pretty much a

> slap on the wrist to get to get their act together on this

> study. To me this is making it seem very unlikely that the

Conserve

> Plus will be approved this year. I am sorry to say that to those

> suffering while waiting. will have to answer the questions

> raised and work to increase the follow-up rate.

>

> Some of the things cited were relatively trivial reporting errors,

> the kind I imagine are easy to slip through the cracks when you are

> dealing with several hundred patients across the country. However,

> after the run-around the FDA gave them with the ceramic study and

> approving their supplier you would think they'd be extra careful on

> this PMA. There were no problems with the devices themselves

failing

> or anything of that nature.

>

> They did cite a problem with missing follow-ups for a number of

> patients. As with the Corin study mentioned recently, please

> get your follow-ups done if you are behind on your one-year or two-

> year anniversary!! I know its hard to do when you are enjoying

> getting back into a pain-free life. Of course, we're probably

> preaching to the choir in this forum.

>

> -

HI ,

Thanks for the post. However I must add that this is where the

Device Companies and the involved surgeons in the trials need to step

up and be responsible. It is unacceptable for there to be problems

with follow-up since this is the primary endpoint which is going to

determine success or failure as far as the FDA is concerned. Shame

on Medical and all the surgeons involved. They deserve the

slap on the wrist. I hope Corin is better at it. For everybody out

there who has undergone hip resurfacing - if you have not had your

yearly follow-up clinic visit please get it scheduled! You owe it to

the rest of us who have not been surfed as of yet. Please do not rob

us of the chance to get the right operation for the the right

disease. To not be responsible for your follow-up is being selfish

and not consistent with the spirit of this website. Everyone

involved has to be responsible for this procedure and that means

device company, surgeon, administrator, and patient alike!

Regards,

Dr. Mark

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> > Did everyone see the warning letter to from the FDA

today?

> Is

> > it the conserve +?

>

> , I saw that, and based on some of the details in the letter, I

> believe it to be about the Conserve Plus study (the name of the

> device and some other details are blanked out for privacy).

>

> I have not asked anyone at about this, but they are always

mum

> on FDA issues involving studies in progress. In another forum some

> people familiar with the industry said the letter was pretty much a

> slap on the wrist to get to get their act together on this

> study. To me this is making it seem very unlikely that the

Conserve

> Plus will be approved this year. I am sorry to say that to those

> suffering while waiting. will have to answer the questions

> raised and work to increase the follow-up rate.

>

> Some of the things cited were relatively trivial reporting errors,

> the kind I imagine are easy to slip through the cracks when you are

> dealing with several hundred patients across the country. However,

> after the run-around the FDA gave them with the ceramic study and

> approving their supplier you would think they'd be extra careful on

> this PMA. There were no problems with the devices themselves

failing

> or anything of that nature.

>

> They did cite a problem with missing follow-ups for a number of

> patients. As with the Corin study mentioned recently, please

> get your follow-ups done if you are behind on your one-year or two-

> year anniversary!! I know its hard to do when you are enjoying

> getting back into a pain-free life. Of course, we're probably

> preaching to the choir in this forum.

>

> -

HI ,

Thanks for the post. However I must add that this is where the

Device Companies and the involved surgeons in the trials need to step

up and be responsible. It is unacceptable for there to be problems

with follow-up since this is the primary endpoint which is going to

determine success or failure as far as the FDA is concerned. Shame

on Medical and all the surgeons involved. They deserve the

slap on the wrist. I hope Corin is better at it. For everybody out

there who has undergone hip resurfacing - if you have not had your

yearly follow-up clinic visit please get it scheduled! You owe it to

the rest of us who have not been surfed as of yet. Please do not rob

us of the chance to get the right operation for the the right

disease. To not be responsible for your follow-up is being selfish

and not consistent with the spirit of this website. Everyone

involved has to be responsible for this procedure and that means

device company, surgeon, administrator, and patient alike!

Regards,

Dr. Mark

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Hi, Group....

I don't want to minimize a " warning letter " from the FDA whatsoever

but it is quite possible that it is a relatively routine occurrence

following on-site audits related to an IDE study. Many citations seem

to be quite technical in nature and I would assume that there can be

very good reasons and explanations for them. Conversely, other

infractions are probably of greater concern to the FDA and, of course,

they need to be corrected. I would be very surprised if sponsors of

other IDE studies in recent years (eg, metal-metal THR,

ceramic-ceramic THR, TKR, etc...) did not also receive similar

" warning " letters.

Could this be an indication that FDA approval is likely to be delayed?

Well, I suppose that anything is possible but I would be very

surprised. I didn't see anything reported in the letter nor am I aware

of any adverse patient outcomes that would result in such a delay.

Keep in mind that the FDA has the authority to " close " the study to

further patient enrollments if serious problems are detected. The

audit was conducted in January and patient enrollment continues

unabated. I am not an authority on this subject nor this particular

FDA audit and, of course, I defer to those who are.

Note, too, that each study site is closely monitored by its own " IRB "

committee at the host hospital. So, I want to assure you that protocol

compliance is monitored not just by the FDA but also by the hospitals'

IRB committees as well as the study sponsor.

Finally, patient compliance with follow-up appointments at the

required post-op intervals is our greatest challenge. A fair number of

patients disregard requests to send us follow-up x-rays and other data

that we are required to report and this makes our job more difficult.

We truly appreciate members' comments that encourage all

" surfacehippies " to keep follow-up appointments at the required intervals.

Regards,

Chuck

JRI

> > Did everyone see the warning letter to from the FDA today?

> Is

> > it the conserve +?

> >

> >

> Hi ,

> What letter is this? Please post.

> Dr. Mark

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Hi, Group....

I don't want to minimize a " warning letter " from the FDA whatsoever

but it is quite possible that it is a relatively routine occurrence

following on-site audits related to an IDE study. Many citations seem

to be quite technical in nature and I would assume that there can be

very good reasons and explanations for them. Conversely, other

infractions are probably of greater concern to the FDA and, of course,

they need to be corrected. I would be very surprised if sponsors of

other IDE studies in recent years (eg, metal-metal THR,

ceramic-ceramic THR, TKR, etc...) did not also receive similar

" warning " letters.

Could this be an indication that FDA approval is likely to be delayed?

Well, I suppose that anything is possible but I would be very

surprised. I didn't see anything reported in the letter nor am I aware

of any adverse patient outcomes that would result in such a delay.

Keep in mind that the FDA has the authority to " close " the study to

further patient enrollments if serious problems are detected. The

audit was conducted in January and patient enrollment continues

unabated. I am not an authority on this subject nor this particular

FDA audit and, of course, I defer to those who are.

Note, too, that each study site is closely monitored by its own " IRB "

committee at the host hospital. So, I want to assure you that protocol

compliance is monitored not just by the FDA but also by the hospitals'

IRB committees as well as the study sponsor.

Finally, patient compliance with follow-up appointments at the

required post-op intervals is our greatest challenge. A fair number of

patients disregard requests to send us follow-up x-rays and other data

that we are required to report and this makes our job more difficult.

We truly appreciate members' comments that encourage all

" surfacehippies " to keep follow-up appointments at the required intervals.

Regards,

Chuck

JRI

> > Did everyone see the warning letter to from the FDA today?

> Is

> > it the conserve +?

> >

> >

> Hi ,

> What letter is this? Please post.

> Dr. Mark

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Don't be alarmed. The warning letter was not sent to patients - it

was sent to Medical from the FDA. It doesn't indicate a

problem with the C+ devices but it does look like there have been some

paperwork screwups that will have to be corrected.

You can read it at: http://www.fda.gov/foi/warning_letters/g4697d.htm

RC2K Dr. Gross 3/24/04

> I have two C+ devices and have not heard a word from anyone.

> Pamela

> 5/10/04 Bilat C+ Dr. S

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Don't be alarmed. The warning letter was not sent to patients - it

was sent to Medical from the FDA. It doesn't indicate a

problem with the C+ devices but it does look like there have been some

paperwork screwups that will have to be corrected.

You can read it at: http://www.fda.gov/foi/warning_letters/g4697d.htm

RC2K Dr. Gross 3/24/04

> I have two C+ devices and have not heard a word from anyone.

> Pamela

> 5/10/04 Bilat C+ Dr. S

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I have two C+ devices and have not heard a word from anyone.

Pamela

5/10/04 Bilat C+ Dr. S

___________

I recieved a note from Dr. Monts office dated May 18, 2004 reminding

me of my remaining followups for my 2 yr and 3 yr. Don't know if that

has anything to do with the FDA Warning letter but i would assume so.

I have not recieved anything like this in the past other than me

personally calling and asking between what specific dates I need to

have them done by. My 3 yr post op appt should fall between the dates

of 9/9/2004 and 9/8/2005 and that was one of the dates they had

highlighted on the letter. Has any other Mont patients recieved this

notice??? The notice was headed: TO: All Research Patients (Conserve

Plus Total Resurfacing Hip System)

L C+ July 11th 2002 MONT

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I have two C+ devices and have not heard a word from anyone.

Pamela

5/10/04 Bilat C+ Dr. S

___________

I recieved a note from Dr. Monts office dated May 18, 2004 reminding

me of my remaining followups for my 2 yr and 3 yr. Don't know if that

has anything to do with the FDA Warning letter but i would assume so.

I have not recieved anything like this in the past other than me

personally calling and asking between what specific dates I need to

have them done by. My 3 yr post op appt should fall between the dates

of 9/9/2004 and 9/8/2005 and that was one of the dates they had

highlighted on the letter. Has any other Mont patients recieved this

notice??? The notice was headed: TO: All Research Patients (Conserve

Plus Total Resurfacing Hip System)

L C+ July 11th 2002 MONT

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Guest guest

I have two C+ devices and have not heard a word from anyone.

Pamela

5/10/04 Bilat C+ Dr. S

___________

I recieved a note from Dr. Monts office dated May 18, 2004 reminding

me of my remaining followups for my 2 yr and 3 yr. Don't know if that

has anything to do with the FDA Warning letter but i would assume so.

I have not recieved anything like this in the past other than me

personally calling and asking between what specific dates I need to

have them done by. My 3 yr post op appt should fall between the dates

of 9/9/2004 and 9/8/2005 and that was one of the dates they had

highlighted on the letter. Has any other Mont patients recieved this

notice??? The notice was headed: TO: All Research Patients (Conserve

Plus Total Resurfacing Hip System)

L C+ July 11th 2002 MONT

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:

I received one also. I got this letter about 2 weeks ago. It was before

anyone here mentioned the warning letter. However, they could still

be connected. I just did my ONE year check up in March and thought it odd

I was getting reminded about my 1, 2 + 3 year check ups so soon after.

Lois

C+ 3/27/03 Dr. Mont

Re: warning letter

I have two C+ devices and have not heard a word from anyone.

Pamela

5/10/04 Bilat C+ Dr. S

___________

I recieved a note from Dr. Monts office dated May 18, 2004 reminding

me of my remaining followups for my 2 yr and 3 yr. Don't know if that

has anything to do with the FDA Warning letter but i would assume so.

I have not recieved anything like this in the past other than me

personally calling and asking between what specific dates I need to

have them done by. My 3 yr post op appt should fall between the dates

of 9/9/2004 and 9/8/2005 and that was one of the dates they had

highlighted on the letter. Has any other Mont patients recieved this

notice??? The notice was headed: TO: All Research Patients (Conserve

Plus Total Resurfacing Hip System)

L C+ July 11th 2002 MONT

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