FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 28 +8.5 BL

MDR report key: 1241023 · Received November 19, 2008

Report

Report Number
1818910-2008-05277
Event Type
Injury
Date Received
November 19, 2008
Date of Event
October 31, 2008
Report Date
October 31, 2008
Manufacturer
DEPUY INTRNATIONAL, LTD.
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, 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

PATIENT WAS REVISED TO ADDRESS DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 28 +8.5 BL 87JDI JDI DEPUY INTRNATIONAL, LTD. NA XVP47

Patients

Seq Age Sex Outcome Treatment
1 71 DA Required Intervention