BEUDAMED
    FDA Adverse Event Other Summary report: N

    X-ALT HIP

    MDR report key: 1971883 · Received January 19, 2011

    Report

    Report Number
    1644408-2011-00042
    Event Type
    Other
    Date Received
    January 19, 2011
    Date of Event
    January 13, 2011
    Report Date
    January 13, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - DUE TO PT HAVING AN INFECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 X-ALT HIP NON-HOODED NEUTRAL LINER LPH ENCORE MEDICAL, L.P. 690F1010

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR Required Intervention (B)(4), LOT 866B1003