FDA Adverse Event
Injury
Summary report: N
ENDURON NEUT 52OD X 28ID
MDR report key: 1983181
·
Received January 31, 2011
Report
- Report Number
- 1818910-2011-01380
- Event Type
- Injury
- Date Received
- January 31, 2011
- Date of Event
- January 4, 2011
- Report Date
- January 4, 2011
- Manufacturer
- DEPUY ORTHOPAEDICS, INC.
- Product Code
- LPH
- PMA / PMN Number
- K944538
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WI, 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 POLY WEAR AND OSTEOLYSIS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ENDURON NEUT 52OD X 28ID | 87HRY; 87HSX; 87JDB; 87JDI; 87JWH; 87KWA; 87KWT | LPH | DEPUY ORTHOPAEDICS, INC. | NA | T3SB51 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Required Intervention |