FDA Adverse Event Other Summary report: N

LIMA HIP

MDR report key: 1981279 · Received February 2, 2011

Report

Report Number
1644408-2011-00053
Event Type
Other
Date Received
February 2, 2011
Date of Event
January 19, 2011
Report Date
January 19, 2011
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
JDI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY - THE PT HAD AN INFECTION. THE DOCTOR REMOVED ALL IMPLANTS AND PLACED IN A FULL LIMA HIP SYS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIMA HIP REVISION DISTAL STEM JDI ENCORE MEDICAL, L.P. 1003773

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention (B)(4), LOT 631C1011| (B)(4), LOT 53877370| (B)(4), LOT 1005533| (B)(4), LOT 53919653