FDA Adverse Event
Injury
Summary report: N
ARTICUL/EZE BALL 28 + 15.5 WH
MDR report key: 1772286
·
Received July 22, 2010
Report
- Report Number
- 1818910-2010-04731
- Event Type
- Injury
- Date Received
- July 22, 2010
- Date of Event
- June 22, 2010
- Report Date
- June 22, 2010
- Manufacturer
- JOHNSON & JOHNSON MEDICAL (DEPUY - SUZHOU) LTD.
- Product Code
- JDI
- PMA / PMN Number
- K883460
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NC, 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
PT WAS REVISED TO ADDRESS INFECTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ARTICUL/EZE BALL 28 + 15.5 WH | 87JDI | JDI | JOHNSON & JOHNSON MEDICAL (DEPUY - SUZHOU) LTD. | NA | D09080143 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 56 YR | Required Intervention |