FDA Adverse Event Injury Summary report: N

ENDURON NEUT 52OD X 28ID

MDR report key: 2060634 · Received April 6, 2011

Report

Report Number
1818910-2011-04821
Event Type
Injury
Date Received
April 6, 2011
Report Date
March 7, 2011
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
KWY
PMA / PMN Number
K940743
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER
Health Professional
N

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

IN (B)(6) 2010, MEDIAL DISLOCATION OF FEMUR OCCURRED. WHEN MANUAL REDUCTION WAS PERFORMED TO TREAT THE DISLOCATION, DISLOCATION OF THE HEAD OUT OF NECK OCCURRED. ON (B)(6) 2010, RE-SURGERY WAS DONE AND THE HEAD AND LINER WERE REPLACED. DURING SURGERY, IT WAS NOTED THAT THE STEM NECK WAS DARKENED. THE STEM WAS NOT REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDURON NEUT 52OD X 28ID 87KWY; 87LZN; 87HRY; 87KWI; 87JDB KWY DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 69 YR Female Required Intervention