FDA Adverse Event Injury Summary report: N

PINN MAR +4 NEUT 32IDX52OD

MDR report key: 1143637 · Received August 28, 2008

Report

Report Number
1818910-2008-03779
Event Type
Injury
Date Received
August 28, 2008
Date of Event
August 4, 2008
Report Date
August 4, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LPH
PMA / PMN Number
K983014
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, 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.

Description of Event or Problem · 1

THE PT WAS REVISED BECAUSE OF DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PINN MAR +4 NEUT 32IDX52OD 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA Y51BP1000

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention