FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 32 +5 BR

MDR report key: 1051146 · Received May 21, 2008

Report

Report Number
1818910-2008-01955
Event Type
Injury
Date Received
May 21, 2008
Date of Event
March 31, 2008
Report Date
April 28, 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
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION WAS NOT POSSIBLE, AS THE DEVICES WERE NOT RETURNED. A COMPLAINT DATABASE SEARCH FINDS NO OTHER REPORTED INCIDENTS AGAINST THE PROVIDED PRODUCT AND LOT CODES SINCE THEIR RELEASE FOR DISTRIBUTION. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT ERROR WITH REGARD TO THE REPORTED EVENT. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED.

Description of Event or Problem · 1

CLINICAL REPORT STATES THE PT WAS REVISED BECAUSE OF DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 32 +5 BR 87JDI JDI DEPUY INTERNATIONAL LTD NA 1143278

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention