FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY UNI FEMORAL

MDR report key: 1080131 · Received July 18, 2008

Report

Report Number
1818910-2008-02855
Event Type
Injury
Date Received
July 18, 2008
Date of Event
June 19, 2008
Report Date
June 19, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
HSA
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION WAS NOT POSSIBLE, AS THE PRODUCT WAS NOT RETURNED. THE INVESTIGATION WAS LIMITED TO THE INFORMATION PROVIDED, AS THE PRODUCT CODE AND LOT NUMBERS REQUIRED TO REVIEW THE DEVICE HISTORY RECORDS AND COMPLAINT HISTORY WERE NOT PROVIDED. THE INVESTIGATION COULD NOT VERIFY OR DRAW ANY CONCLUSIONS ABOUT THE REPORTED EVENT BASED ON THE PROVIDED INFORMATION. THE INITIAL REPORT STATES THAT IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS OR CONTRIBUTED TO THE REPORTED EVENT. 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

THE PATIENT WAS REVISED BECAUSE OF PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY UNI FEMORAL TOTAL KNEE PROSTHESIS HSA DEPUY ORTHOPAEDICS, INC. NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 51 YR Required Intervention