FDA Adverse Event Injury Summary report: N

ENDURON 10D 48OD X 28ID

MDR report key: 1954490 · Received January 5, 2011

Report

Report Number
1818910-2010-10784
Event Type
Injury
Date Received
January 5, 2011
Date of Event
December 6, 2010
Report Date
December 6, 2010
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LPH
PMA / PMN Number
K944538
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

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 REPORT STATES THE PT WAS REVISED TO ADDRESS PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDURON 10D 48OD X 28ID 87HRY LPH DEPUY ORTHOPAEDICS, INC. NA R39DX1040

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention