FDA Adverse Event Injury Summary report: N

ORTHOMET(R) COBALT CHROME FEMORAL HEAD

MDR report key: 1850592 · Received October 1, 2010

Report

Report Number
1043534-2010-00401
Event Type
Injury
Date Received
October 1, 2010
Date of Event
August 19, 2010
Report Date
May 2, 2011
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
JDI
PMA / PMN Number
K880461
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. ATTEMPTS ARE BEING MADE TO HAVE THE DEVICE RETURNED FOR EVALUATION. TRENDS WILL BE EVAULATED. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGAITON IS COMPLETE. THIS IS THE SAME EVENT AS 1043534-2010-00400. THIS EVENT OCCURRED IN (B)(6).

Additional Manufacturer Narrative · 1

CONCLUSION: NORMAL WEAR. COMPLAINT HISTORY REVIEWED. DEVICE HISTORY RECORD REVIEWED. EVIDENCE THAT PRODUCT IN SPEC WHEN USED. USE OF DEVICE COULD NOT BE DETERMINED.

Description of Event or Problem · 1

ALLEGEDLY AFTER 13 YEARS OF IMPLANTATION, THIS COMPONENT IS REMOVED DURING THE REVISION OF ANOTHER COMPONENT.

Description of Event or Problem · 1

ALLEGEDLY AFTER 13 YEARS OF IMPLANTATION, THIS COMPONENT IS REMOVED DURING THE REVISION OF ANOTHER COMPONENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ORTHOMET(R) COBALT CHROME FEMORAL HEAD HIP COMPONENT JDI WRIGHT MEDICAL TECHNOLOGY, INC. 027A058204

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R