BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LCS FEM 65MM STD LT

    MDR report key: 1884720 · Received October 22, 2010

    Report

    Report Number
    1818910-2010-07684
    Event Type
    Injury
    Date Received
    October 22, 2010
    Date of Event
    September 22, 2010
    Report Date
    September 22, 2010
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    NJL
    PMA / PMN Number
    P830055/S001
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NZ
    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 HAS BEEN EXPERIENCING KNEE PAIN AND INSTABILITY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LCS FEM 65MM STD LT 87NJL NJL DEPUY ORTHOPAEDICS, INC. NA 940790

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention