BEUDAMED
    FDA Adverse Event Other Summary report: N

    ENCORE/DJO SURGICAL HIP SYSTEM

    MDR report key: 1530936 · Received October 27, 2009

    Report

    Report Number
    1644408-2009-00508
    Event Type
    Other
    Date Received
    October 27, 2009
    Date of Event
    September 29, 2009
    Report Date
    September 29, 2009
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - SUBSIDENCE OF CEMENT MANTLE, CAUSING STEM TO LOOSEN AND SETTLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENCORE/DJO SURGICAL HIP SYSTEM UNK JDI ENCORE MEDICAL, L.P. UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Required Intervention