FDA Adverse Event Injury Summary report: N

PINN MAR +4 10D 36IDX52OD

MDR report key: 1143647 · Received August 28, 2008

Report

Report Number
1818910-2008-03799
Event Type
Injury
Date Received
August 28, 2008
Date of Event
August 5, 2008
Report Date
August 5, 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
FL, 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 OR 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 A MRSA INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PINN MAR +4 10D 36IDX52OD 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA CW1GX1

Patients

Seq Age Sex Outcome Treatment
1 87 YR Required Intervention