FDA Adverse Event Injury Summary report: N

PINN MAR +4NEUT 32IDX54OD

MDR report key: 1192007 · Received October 6, 2008

Report

Report Number
1818910-2008-04205
Event Type
Injury
Date Received
October 6, 2008
Date of Event
September 16, 2008
Report Date
September 16, 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
VA, US
Reporter Occupation
PHYSICIAN

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 PROD AND LOT CODES SINCE THEIR RELEASE FOR DISTRIBUTION. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PROD 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

PT WAS REVISED TO ADDRESS REPEAT DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PINN MAR +4NEUT 32IDX54OD 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA A3VB91000

Patients

Seq Age Sex Outcome Treatment
1 74 YR Required Intervention