FDA Adverse Event Injury Summary report: N

LCS CRUC M/B PAT REPLAC GVF LG

MDR report key: 1581430 · Received January 15, 2010

Report

Report Number
1818910-2009-08041
Event Type
Injury
Date Received
January 15, 2010
Date of Event
December 16, 2009
Report Date
December 16, 2009
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
NJL
PMA / PMN Number
P8300055
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LCS CRUC M/B PAT REPLAC GVF LG 87NJL NJL DEPUY ORTHOPAEDICS, INC. NA 2410367

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention