FDA Adverse Event Injury Summary report: N

ENDURANCE SZ 3 HIGH OFFSET

MDR report key: 1013871 · Received March 14, 2008

Report

Report Number
1818910-2008-00866
Event Type
Injury
Date Received
March 14, 2008
Date of Event
February 26, 2008
Report Date
February 26, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JDI
PMA / PMN Number
K942370
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION WAS NOT POSSIBLE, AS THE DEVICE WAS NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS WAS ALSO NOT POSSIBLE AS THE LOT CODE REQUIRED FOR RETRIEVAL WAS UNAVAILABLE. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT ERROR REGARDING THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

PATIENT REVISED TO ADDRESS LOOSE FEMORAL COMPONENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDURANCE SZ 3 HIGH OFFSET 87JDI JDI DEPUY ORTHOPAEDICS, INC. NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention