FDA Adverse Event
Injury
Summary report: N
ARTICULEZE M HEAD 36MM +1.5
MDR report key: 1962475
·
Received January 7, 2011
Report
- Report Number
- 1818910-2011-00249
- Event Type
- Injury
- Date Received
- January 7, 2011
- Date of Event
- December 10, 2010
- Report Date
- December 10, 2010
- Manufacturer
- DEPUY INTERNATIONAL, LTD.
- Product Code
- JDI
- PMA / PMN Number
- K980513
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MD, 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
PATIENT WAS REVISED TO ADDRESS LOOSENING OF THE CUP AND GRAY TISSUE AROUND CAPSULE. OSTEOLYSIS WAS ALSO REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ARTICULEZE M HEAD 36MM +1.5 | 87JDI; 87LPH | JDI | DEPUY INTERNATIONAL, LTD. | NA | 2307466 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Required Intervention |