FDA Adverse Event Injury Summary report: N

DUR MAR +4 10D LNR 36X62

MDR report key: 1020292 · Received March 25, 2008

Report

Report Number
1818910-2008-00956
Event Type
Injury
Date Received
March 25, 2008
Date of Event
March 11, 2008
Report Date
March 11, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LPH
PMA / PMN Number
K010171
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION WAS NOT POSSIBLE, AS THE DEVICES WERE NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS WAS ALSO NOT POSSIBLE AS THE LOT CODES REQUIRED FOR RETRIEVAL WERE UNAVAILABLE. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT ERROR WITH REGARD TO THE REPORTED EVENT WITH THE INFO AVAILABLE. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED.

Description of Event or Problem · 1

THE PT WAS REVISED BECAUSE OF DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DUR MAR +4 10D LNR 36X62 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 55 YR Required Intervention