FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 28+1.5 GR

MDR report key: 1053446 · Received May 27, 2008

Report

Report Number
1818910-2008-01991
Event Type
Injury
Date Received
May 27, 2008
Date of Event
May 14, 2008
Report Date
May 14, 2008
Manufacturer
DEPUY INTL, LTD
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

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 PROD AND LOT CODES SINCE THEIR RELEASE FOR DISTRIBUTION. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PROD 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

PT WAS REVISED TO ADDRESS INFECTION AND LOOSENING OF THE STEM AND CUP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 28+1.5 GR 87JDI JDI DEPUY INTL, LTD NA 2480672

Patients

Seq Age Sex Outcome Treatment
1 58 YR Required Intervention