FDA Adverse Event Other Summary report: N

SROM NCK TRL 36MM STD +6 LAT

MDR report key: 1885393 · Received October 22, 2010

Report

Report Number
1818910-2010-07354
Event Type
Other
Date Received
October 22, 2010
Date of Event
September 24, 2010
Report Date
February 27, 2026
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LXH
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER
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

THE PT'S GREATER TROCHANTER WAS FRACTURED WHILE TRIALING. THIS WAS AN SROM SURGERY WITH A 16X11 TRIAL STEM AND 36+6 NECK TRIAL. THE NECK TRIAL IS LARGER THAN THE ACTUAL IMPLANT IN THE LATERAL SHOULDER REGION. THE SURGEON SAYS THE FRACTURE WOULD NOT HAVE HAPPENED IF THE TRIAL WAS THE SAME SIZE AS THE ACTUAL IMPLANT. THIS CAUSED A ONE (1) HOUR SURGICAL DELAY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SROM NCK TRL 36MM STD +6 LAT 87LXH LXH DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 Female Required Intervention