FDA Adverse Event Injury Summary report: N

ENDURON NEUT 52OD X 28ID

MDR report key: 1983565 · Received January 31, 2011

Report

Report Number
1818910-2011-01295
Event Type
Injury
Date Received
January 31, 2011
Date of Event
January 5, 2011
Report Date
January 5, 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
WA, 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

THE PT WAS REVISED TO ADDRESS POLY WEAR OF THE LINER AND STEM LOOSENING. IT WAS REPORTED THAT A COMPETITOR'S CEMENT WAS USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDURON NEUT 52OD X 28ID 87HRY, HSX, JDB, JDI, KWA LPH DEPUY ORTHOPAEDICS, INC. NA RP7BV1003

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention