FDA Adverse Event Injury Summary report: N

LCS COMPLETE M/B PAT CEM LG

MDR report key: 1250766 · Received December 2, 2008

Report

Report Number
1818910-2008-05630
Event Type
Injury
Date Received
December 2, 2008
Date of Event
November 14, 2008
Report Date
November 14, 2008
Manufacturer
DEPUY-CORK, A DIVISION OF DEPUY ORTHOPAEDICS
Product Code
NJL
PMA / PMN Number
P830055/R44
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION WAS NOT POSSIBLE, AS THE PRODUCTS WERE NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE DID NOT SHOW ANY OTHER REPORTS AGAINST THE MANUFACTURING LOTS. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE REPORTED DEVICE LOOSENING OR INFECTION. INFECTION AFTER APPROXIMATELY 2-1/2 YEARS IMPLANTATION IS UNLIKELY TO BE PRODUCT RELATED. NO EVIDENCE WAS FOUND SUGGESTING PRODUCT ERROR WAS A CONTRIBUTING FACTOR AND THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCTS AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

THE PATIENT WAS REVISED BECAUSE OF INFECTION WITH LOOSENING OF THE FEMORAL COMPONENT, TIBIAL COMPONENT AND PATELLA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LCS COMPLETE M/B PAT CEM LG 87NJL NJL DEPUY-CORK, A DIVISION OF DEPUY ORTHOPAEDICS N/A 2025567

Patients

Seq Age Sex Outcome Treatment
1 71 YR Required Intervention