FDA Adverse Event Injury Summary report: N

PROFEMUR Z STEM PLASMA SPRAYED

MDR report key: 1021985 · Received March 28, 2008

Report

Report Number
1043534-2008-00045
Event Type
Injury
Date Received
March 28, 2008
Date of Event
March 12, 2008
Report Date
March 6, 2008
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
LPH
PMA / PMN Number
K021346
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. ADD'L INFO HAS BEEN REQUESTED. ATTEMPTS HAVE BEEN MADE TO HAVE THE DEVICE RETURNED FOR EVAL. ALTHOUGH SEVERAL ATTEMPTS HAVE BEEN MADE, A MEDWATCH 3500A HAS NOT BEEN REC'D. THIS REPORT WILL BE AMENDED WHEN THE INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 1043534-2008-00043, 00044, 00046.

Description of Event or Problem · 1

ALLEGEDLY FEMORAL NECK IS BROKEN. NO TRAUMA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROFEMUR Z STEM PLASMA SPRAYED LPH WRIGHT MEDICAL TECHNOLOGY, INC. V01135583

Patients

Seq Age Sex Outcome Treatment
1 52 YR Hospitalization| R