FDA Adverse Event Injury Summary report: N

PINN MAR +4 NEUT 36IDX52OD

MDR report key: 1090223 · Received July 30, 2008

Report

Report Number
1818910-2008-03153
Event Type
Injury
Date Received
July 30, 2008
Date of Event
July 9, 2008
Report Date
July 9, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LPH
PMA / PMN Number
K033273
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. A COMPLAINT DATABASE SEARCH FINDS NO OTHER REPORTED INCIDENTS AGAINST THE PROVIDED PRODUCT AND LOT CODES SINCE THEIR RELEASE FOR DISTRIBUTION. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT ERROR WITH REGARD TO THE REPORTED EVENT. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFO THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

PT REVISED TO ADDRESS DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PINN MAR +4 NEUT 36IDX52OD 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA BJ3BV1000

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention