FDA Adverse Event Injury Summary report: N

PROFEMUR MODULAR FEMORAL NECK

MDR report key: 1251271 · Received December 4, 2008

Report

Report Number
1043534-2008-00343
Event Type
Injury
Date Received
December 4, 2008
Date of Event
November 24, 2008
Report Date
November 24, 2008
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
LWJ
PMA / PMN Number
K003016
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. THE DEVICE EVENT CODE IS ADDRESSED IN THE PACKAGE INSERT. ADDITIONAL INFO HAS BEEN REQUESTED. TRENDS WILL BE EVALUATED. ALTHOUGH SEVERAL ATTEMPTS HAVE BEEN MADE, A MEDWATCH 3500A HAS NOT BEEN RECEIVED FROM THE USER FACILITY. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 1043534-2008-00344, 00345.

Description of Event or Problem · 1

ALLEGEDLY REVISED DUE TO FRACTURED MODULAR NECK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROFEMUR MODULAR FEMORAL NECK LWJ WRIGHT MEDICAL TECHNOLOGY, INC. NA U0370580

Patients

Seq Age Sex Outcome Treatment
1 60 YR Hospitalization| R