FDA Adverse Event Other Summary report: N

KERAMOS HIP

MDR report key: 1880581 · Received October 20, 2010

Report

Report Number
1644408-2010-00562
Event Type
Other
Date Received
October 20, 2010
Date of Event
October 12, 2010
Report Date
October 12, 2010
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
LZO
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY - PELVIC FRACTURE, REMOVED SHELL AND REPLACED WITH CERAMIC SLEEVE AND HEAD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KERAMOS HIP FLARED RIM SHELL CERAMIC-CERAMIC LZO ENCORE MEDICAL, L.P. UNK

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention