FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 28 +8.5 BL

MDR report key: 1061398 · Received June 16, 2008

Report

Report Number
1818910-2008-02474
Event Type
Injury
Date Received
June 16, 2008
Date of Event
May 29, 2008
Report Date
May 29, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, 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 PRODUCT AND/OR LOT CODES 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 THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

PATIENT REVISED TO ADDRESS DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 28 +8.5 BL 87JDI JDI DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention