BEUDAMED
    FDA Adverse Event Other Summary report: N

    FOUNDATION HIP SYSTEM

    MDR report key: 1031767 · Received April 18, 2008

    Report

    Report Number
    1644408-2008-00121
    Event Type
    Other
    Date Received
    April 18, 2008
    Date of Event
    March 26, 2008
    Report Date
    April 17, 2008
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    KWY
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - FRACTURED FEMUR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOUNDATION HIP SYSTEM HIP STEM, HA COATED KWY ENCORE MEDICAL, L.P. 53862094

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Required Intervention 411-00-350/53910273| 497-38-000/53806845