FDA Adverse Event Injury Summary report: N

UNK DEPUY PATELLA

MDR report key: 1241045 · Received November 19, 2008

Report

Report Number
1818910-2008-05509
Event Type
Injury
Date Received
November 19, 2008
Date of Event
October 24, 2008
Report Date
October 24, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
HTG
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION WAS NOT POSSIBLE, AS THE PRODUCT WAS NOT RETURNED. THE INVESTIGATION WAS LIMITED TO THE INFO PROVIDED, AS THE PRODUCT CODE AND LOT NUMBERS REQUIRED TO REVIEW THE DEVICE HISTORY RECORDS AND COMPLAINT HISTORY WERE NOT PROVIDED. THE INVESTIGATION COULD NOT VERIFY OR DRAW ANY CONCLUSIONS ABOUT THE REPORTED EVENT BASED ON THE PROVIDED INFO. THE INITIAL REPORT STATES THAT IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS OR CONTRIBUTED TO THE REPORTED EVENT. THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFO BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

PT REVISED FOR OSTEOLYSIS, POLYWEAR, AND PATELLAR LOOSENING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNK DEPUY PATELLA TOTAL KNEE REPLACEMENT HTG DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 69 YR Required Intervention