BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ARTICUL/EZE BALL 28 +1.5 GR

    MDR report key: 2002733 · Received February 17, 2011

    Report

    Report Number
    1818910-2011-02474
    Event Type
    Injury
    Date Received
    February 17, 2011
    Date of Event
    November 10, 2003
    Report Date
    January 18, 2011
    Manufacturer
    DEPUY INTERNATIONAL, LTD.
    Product Code
    JDI
    PMA / PMN Number
    K883460
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    UNKNOWN

    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

    PT CONTACTED DEPUY TO REPORT REVISION. DOCTOR'S NOTES INDICATE THE REASON FOR REVISION AS RECURRENT DISLOCATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ARTICUL/EZE BALL 28 +1.5 GR 87JDI JDI DEPUY INTERNATIONAL, LTD. NA 1054378

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention