FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY FEMORAL

MDR report key: 1903327 · Received November 16, 2010

Report

Report Number
1818910-2010-08493
Event Type
Injury
Date Received
November 16, 2010
Date of Event
October 21, 2010
Report Date
October 21, 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
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT ASSOCIATED WITH THIS REPORTED EVENT WAS NOT RETURNED FOR EXAMINATION. PRODUCT INFO REQUIRED IN SEARCHING THE COMPLAINT DATABASE BY LOT CODE WAS NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE REPORTED EVENT WITHOUT THE PRODUCT TO EXAMINE AND INSUFFICIENT PRODUCT INFO. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFO BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

PT WAS REVISED TO ADDRESS PAIN.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 69 YR Required Intervention