FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY SZ4 CR FEMORAL COMPONENT

MDR report key: 1885138 · Received October 22, 2010

Report

Report Number
1818910-2010-07935
Event Type
Injury
Date Received
October 22, 2010
Date of Event
September 29, 2010
Report Date
September 29, 2010
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JWH
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT ASSOCIATED WITH THIS REPORTED EVENT WAS NOT RETURNED. PRODUCT INFORMATION REQUIRED IN RETRIEVING THE DEVICE HISTORY RECORDS FOR REVIEWING AND SEARCHING THE COMPLAINT DATABASE WAS NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE REPORTED INFECTION. BASED ON THE PERFORMED INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY SZ4 CR FEMORAL COMPONENT TOTAL KNEE PROSTHESIS JWH DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 61 YR