FDA Adverse Event Injury Summary report: N

APEX

MDR report key: 1080771 · Received July 14, 2008

Report

Report Number
1080771
Event Type
Injury
Date Received
July 14, 2008
Date of Event
May 1, 2008
Report Date
June 9, 2008
Manufacturer
APEX, INC
Product Code
KWY
Adverse Event
Yes
Report Source
User Facility report
Reporter Location
OK, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

PT WAS ADMITTED FOR REMOVAL OF IMPLANT FROM PREVIOUS TOTAL HIP SURGERY & PLACEMENT OF NEW HARDWARE, SECONDARY TO PAIN & DECREASED RANGE OF MOTION. IN ACCORDANCE WITH HOSPITAL POLICY, THE COMPONENTS REMOVED ARE NOT AVAILABLE FOR RELEASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 APEX SEE ATTACHED KWY APEX, INC SEE ATTACHED SEE ATTACHED

Patients

Seq Age Sex Outcome Treatment
1 77 YR Hospitalization| R