BEUDAMED
    FDA Adverse Event Injury Summary report: N

    APEX

    MDR report key: 1130663 · Received August 11, 2008

    Report

    Report Number
    1130663
    Event Type
    Injury
    Date Received
    August 11, 2008
    Date of Event
    July 3, 2008
    Report Date
    July 14, 2008
    Manufacturer
    APEX
    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 REVISION OF RIGHT TOTAL HIP, SECONDARY TO PAIN & INFECTION WITH STAPH AUREUS. SENDING ALL DOCUMENTATION AVAILABLE ON COMPONENTS. IN ACCORDANCE WITH HOSP 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 SEE ATTACHED SEE ATTACHED

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Hospitalization| R