FDA Adverse Event Injury Summary report: N

LCS COMP RP INSERT LG 10MM

MDR report key: 2011299 · Received March 4, 2011

Report

Report Number
1818910-2011-02563
Event Type
Injury
Date Received
March 4, 2011
Date of Event
February 2, 2011
Report Date
February 2, 2011
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
NJL
PMA / PMN Number
P830055/S074
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE LCS DUO-FIX FEMORAL COMPONENTS WERE VOLUNTARILY RECALLED FROM THE MARKET IN JULY 2009, AND THE LCS DUO-FIX FEMORAL PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INSPECTION OF COMPONENTS WILL NOT BE PERFORMED AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. REF. WWCAPA (B)(4). WHERE INDIVIDUAL RETRIEVAL ANALYSIS IS UNDERTAKEN TO CONFIRM THE PRESENCE OF ALUMINA IN THE POLY BEARING SURFACE THEN THESE REVIEWS WILL BE ATTACHED TO THE COMPLAINT RECORD. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

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

REVISION TOTAL KNEE REPLACEMENT DUE TO THIRD BODY WEAR. PAIN AND SWELLING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LCS COMP RP INSERT LG 10MM 87 NJL NJL DEPUY ORTHOPAEDICS, INC. NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 66 YR Required Intervention