The DePuy ASR Acetabular Hip Replacement System that was recalled last August is making headlines in Australia for severe pain, failing hip implants, the need for painful and complicated revision surgery, and reports of illness linked to metal toxicity.

A metal-on-metal device made of chromium and cobalt, the DePuy ASR Hip Implant System consists of a cup implanted into the hip with a ball joint that connects to the leg. Many of the nation’s leading orthopedic surgeons have reduced or stopped use of these devices because of concerns that they can cause severe tissue and bone damage.

It is believed that many of the complications linked to the DePuy ASR implant and similar metal-on-metal devices are caused by wearing of their metal components, which can allow metal shavings to make their way into patients’ bloodstreams, leading to tissue breakdown, bone loss, the formation of non-cancerous tumors, and even cobalt poisoning. Many victims of the DePuy ASR hip implant have tested with elevated metal ion levels in their blood. Many of these victims could face long-term health problems if their metal poisoning is left untreated.

Australia’s ABC Four Corners said that, in addition to many patients who have suffered from an array of complaints concerning pain and pain when moving, many in Australia reportedly have adverse medical events attributed to metal poisoning from the DePuy Joint. Many patients implanted with the defective metal-on-metal joint have tested with increased cobalt and chromium blood levels, two of the metals used in the making of these recalled joints.

One patient told ABC that the cobalt from his defective DePuy hip eroded his thighbone—the area of his implant—and said his surgeon described the area in which the now-removed joint had been implanted saying, “My flesh had turned a grey black around the hip area.” The patient said that his physician said that the bone, “looked like a sewer pipe and was full of a sludgy grey material,” quoted Four Corners. The patient also reported tinnitus and vision problems he blames on cobalt poisoning.

A different patient said she received a cobalt blood reading 50 times higher than the acceptable limit and that she suffered for years with “inexplicable serious illness” prior to the removal of the defective implant, said Four Corners.

According to one English researcher, said Four Corners, the DePuy debacle is “perhaps the biggest disaster in the history of orthopaedics.” Now, said Four Corners, an inquiry into how Australia regulates the medical device industry. Four Corners’ report presented evidence that labs are seeing increased cobalt toxicity levels in patients reporting ASR implant failure. “We’re talking serious toxicity in a large number of patients that have received faulty hip joints,” a specialist chemical pathologist said, quoted Four Corners.

The DePuy ASR Acetabular Hip Replacement System was recalled last August, after data from a registry in the United Kingdom indicated a failure rate of 12 percent within five years of implantation. Since that recall, at least 1,000 DePuy ASR hip implant lawsuits have been filed by victims of the device in federal and state courts around the country. Hundreds of such claims have been consolidated in a multidistrict litigation in U.S. District Court for the Northern District of Ohio.