FDA Adverse Event Injury Summary report: N

ARTICULEZE M HEAD 36MM + 1.5

MDR report key: 1241018 · Received November 19, 2008

Report

Report Number
1818910-2008-05255
Event Type
Injury
Date Received
November 19, 2008
Date of Event
October 29, 2008
Report Date
October 29, 2008
Manufacturer
DEPUY INTERNATIONAL, LTD
Product Code
JDI
PMA / PMN Number
K980513
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION WAS NOT POSSIBLE, AS THE DEVICE WAS NOT RETURNED. A COMPLAINT DATABASE SEARCH FINDS NO OTHER REPORTED INCIDENTS AGAINST THE PROVIDED PRODUCT AND LOT CODE SINCE ITS 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

PATIENT WAS REVISED TO ADDRESS INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICULEZE M HEAD 36MM + 1.5 87JDI; 87LPH JDI DEPUY INTERNATIONAL, LTD NA 2723269

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention