BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEPUY

    MDR report key: 2071882 · Received April 23, 2011

    Report

    Report Number
    MW5020393
    Event Type
    Injury
    Date Received
    April 23, 2011
    Date of Event
    August 5, 2008
    Report Date
    April 23, 2011
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    KXA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) 2008, I HAD A HIP REPLACEMENT USING THE DEPUY PINNACLE HARDWARE. ON (B)(6) 2008, THE HIP BECAME DISLOCATED AND REQUIRED A VISIT TO THE ER ON (B)(6) 2008 TO RE-SET THE HIP. THE HIP SUBSEQUENTLY BECAME DISLOCATED THREE (3) MORE TIMES BEFORE A REVISION SURGERY COULD BE PERFORMED ON (B)(6) 2008. ON (B)(6) 2008 THERE WAS A REVISION SURGERY USING THE DEPUY PINNACLE HARDWARE WITH A LINING THAT SECURES THE HIP SO THAT IT COULD NOT BECOME DISLOCATED ANY MORE. THESE DISLOCATIONS CAUSED EXCRUCIATING PAIN EACH TIME AND MY HIP NOW OFTEN ACHES AND I ALWAYS FAVOR IT FEARING THAT IT WILL BECOME DISLOCATED AGAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DEPUY PINNACLE FEMORAL HEAD KXA DEPUY ORTHOPAEDICS, INC. 2703214

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Hospitalization| S