FDA Adverse Event
Injury
Summary report: N
UNK DEPUY ASR UNI FEMORAL IMPLANT
MDR report key: 1884760
·
Received October 22, 2010
Report
- Report Number
- 1818910-2010-07922
- Event Type
- Injury
- Date Received
- October 22, 2010
- Date of Event
- October 18, 2010
- Report Date
- October 18, 2010
- Manufacturer
- DEPUY INTERNATIONAL, LTD.
- Product Code
- KWY
- PMA / PMN Number
- NA
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TN, US
- Reporter Occupation
- UNKNOWN
- Health Professional
- N
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
LITIGATION PAPERS ALLEGED, PATIENT WAS HOSPITALIZED DUE TO INFECTION IN THE AREA OF THE ASR IMPLANT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNK DEPUY ASR UNI FEMORAL IMPLANT | TOTAL HIP REPLACEMENT | KWY | DEPUY INTERNATIONAL, LTD. | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Male | Required Intervention |