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Precaution, governance and the failure of medical implants: the ASR(TM) hip in the UK

Lookup NU author(s): Dr Matthias Wienroth, Dr Pauline McCormack, Professor Tom Joyce



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Hip implants have provided life-changing treatment, reducing pain and improving the mobility and independence of patients. Success has encouraged manufacturers to innovate and amend designs, engendering patient hopes in these devices. However, failures of medical implants do occur. The failure rate of the Articular Surface Replacement metal-on-metal hip system, implanted almost 100,000 times world-wide, has re-opened debate about appropriate and timely implant governance. As commercial interests, patient hopes, and devices’ governance converge in a socio-technical crisis, we analyse the responses of relevant governance stakeholders in the United Kingdom between 2007 and 2014. We argue that there has been a systemic failure of the governance system entrusted with the safety of patients fitted with medical implants. Commercial considerations of medical implants and the status quo of medical implant governance have been given priority over patient safety despite the availability of significant failure data in an example of uncertainty about what constitutes appropriate precautionary action.

Publication metadata

Author(s): Wienroth M, McCormack P, Joyce T

Publication type: Article

Publication status: Published

Journal: Life Sciences, Society and Policy

Year: 2014

Volume: 10

Issue: 19

Pages: 16

Print publication date: 26/11/2014

Online publication date: 26/11/2014

Acceptance date: 01/11/2014

Date deposited: 15/06/2016

ISSN (electronic): 2195-7819

Publisher: SpringerOpen


DOI: 10.1186/s40504-014-0019-2


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