FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 32 + 1 GR

MDR report key: 1040115 · Received May 7, 2008

Report

Report Number
1818910-2008-01629
Event Type
Injury
Date Received
May 7, 2008
Date of Event
April 22, 2008
Report Date
April 22, 2008
Manufacturer
DEPUY INTERNATIONAL LTD.
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, 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 CONTRIBUTION/ERROR WITH REGARD TO THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS DISLOCATION (RIGHT SIDE).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 32 + 1 GR 87JDI JDI DEPUY INTERNATIONAL LTD. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention