FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY FEMORAL COMPONENT

MDR report key: 1800848 · Received August 10, 2010

Report

Report Number
1818910-2010-05533
Event Type
Injury
Date Received
August 10, 2010
Date of Event
July 20, 2010
Report Date
July 20, 2010
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
KWY
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT ASSOCIATED WITH THIS REPORTED EVENT WAS NOT RETURNED FOR EXAMINATION. THE PRODUCT CODE AND LOT CODE REQUIRED TO SEARCH THE COMPLAINT DATABASE WERE NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE REPORTED EVENT BASED ON THE LACK OF THE PRODUCT TO EXAMINE AND INSUFFICIENT PRODUCT INFO. PROVIDED INFO STATED PRODUCT MALPOSITIONING WAS A CONTRIBUTING FACTOR AND THE PRODUCT WAS NOT SUSPECTED OF FAILING TO MEET SPECIFICATIONS OR BEING A CONTRIBUTING FACTOR TO THE EVENT. BASED ON THE PERFORMED INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFO BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

PT REVISED FOR FEMORAL MALPOSITIONING, PAIN AND INSTABILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY FEMORAL COMPONENT TOTAL KNEE REPLACEMENT KWY DEPUY ORTHOPAEDICS, INC. NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention