FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUPS 54

MDR report key: 1933649 · Received December 17, 2010

Report

Report Number
1818910-2010-09737
Event Type
Injury
Date Received
December 17, 2010
Date of Event
November 17, 2010
Report Date
February 6, 2026
Manufacturer
DEPUY INTERNATIONAL, LTD.
Product Code
KWA
PMA / PMN Number
K040627
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
GA, 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

PATIENT WAS REVISED TO ADDRESS PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ASR ACETABULAR CUPS 54 87KWA KWA DEPUY INTERNATIONAL, LTD. NA 2522187

Patients

Seq Age Sex Outcome Treatment
1 Male