BEUDAMED
    FDA Adverse Event Other Summary report: N

    LIMA HIP

    MDR report key: 2011719 · Received March 1, 2011

    Report

    Report Number
    1644408-2011-00108
    Event Type
    Other
    Date Received
    March 1, 2011
    Date of Event
    February 18, 2011
    Report Date
    February 18, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - DUE TO DISLOCATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIMA HIP ACETABULAR CAGE STANDARD JDI ENCORE MEDICAL, L.P. 1007549

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Required Intervention (B)(4), LOT 54037709| (B)(4), LOT 728F1010| (B)(4), LOT 009A1000| (B)(4), LOT 53951738| (B)(4), LOT 53944939| (B)(4), LOT 903B1002