BEUDAMED
    FDA Adverse Event Other Summary report: N

    FMP ACETABULAR LINERS

    MDR report key: 1080983 · Received July 23, 2008

    Report

    Report Number
    1644408-2008-00230
    Event Type
    Other
    Date Received
    July 23, 2008
    Date of Event
    June 19, 2008
    Report Date
    June 30, 2008
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    KWB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - PT WAS ADMITTED FOR REVISION OF LEFT TOTAL HIP, SECONDARY TO PAIN AND RECURRENT DISLOCATIONS. NOTE: INFO REVIEWED VIA A MEDWATCH FORM FROM THE HOSP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FMP ACETABULAR LINERS LINER KWB ENCORE MEDICAL, L.P. 856561

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Required Intervention 430-03-048/693321