FDA Adverse Event Injury Summary report: N

PROFEMUR Z STEM PLASMA SPRAYED

MDR report key: 1222519 · Received November 6, 2008

Report

Report Number
1043534-2008-00319
Event Type
Injury
Date Received
November 6, 2008
Date of Event
October 21, 2008
Report Date
October 21, 2008
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
LPH
PMA / PMN Number
K021346
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. ADDITIONAL INFORMATION HAS BEEN REQUESTED. ATTEMPTS ARE BEING MADE TO HAVE THE IMPLANT RETURNED FOR EVALUATION. THE EVENT DEVICE CODE IS ADDRESSED IN THE PACKAGE INSERT. TRENDS WILL BE EVALUATED. ALTHOUGH SEVERAL ATTEMPTS HAVE BEEN MADE, A MEDWATCH 3500A HAS NOT BEEN RECEIVED FROM THE USER FACILITY AT THIS TIME. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 1043534-2008-00318.

Description of Event or Problem · 1

ALLEGEDLY REMOVED STEM DURING REVISION OF NECK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROFEMUR Z STEM PLASMA SPRAYED LPH WRIGHT MEDICAL TECHNOLOGY, INC. NA 056334875

Patients

Seq Age Sex Outcome Treatment
1 NI Hospitalization| R