BEUDAMED
    FDA Adverse Event Other Summary report: N

    FOUNDATION HIP SYSTEM

    MDR report key: 1023514 · Received March 28, 2008

    Report

    Report Number
    1644408-2008-00115
    Event Type
    Other
    Date Received
    March 28, 2008
    Date of Event
    March 1, 2008
    Report Date
    March 28, 2008
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    KWB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - PT HAD AN INFECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOUNDATION HIP SYSTEM BIPOLAR SHELL KWB ENCORE MEDICAL, L.P. 53867165

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Required Intervention