FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 32 +9 BL

MDR report key: 1962489 · Received January 7, 2011

Report

Report Number
1818910-2011-00243
Event Type
Injury
Date Received
January 7, 2011
Date of Event
April 11, 2006
Report Date
December 10, 2010
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, 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 REVISED DUE TO DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 32 +9 BL 87 JDI JDI DEPUY ORTHOPAEDICS, INC. NA 1892945

Patients

Seq Age Sex Outcome Treatment
1 76 YR Required Intervention