BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEPUY ASR XL FEM IMP SIZE 55

    MDR report key: 2082854 · Received May 3, 2011

    Report

    Report Number
    1818910-2011-06990
    Event Type
    Injury
    Date Received
    May 3, 2011
    Date of Event
    April 11, 2011
    Report Date
    March 13, 2026
    Manufacturer
    DEPUY INTERNATIONAL, LTD.
    Product Code
    KWA
    PMA / PMN Number
    NA
    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

    THE PATIENT WAS REVISED TO ADDRESS ALVAL AND SUBSEQUENT PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DEPUY ASR XL FEM IMP SIZE 55 87KWA KWA DEPUY INTERNATIONAL, LTD. NA 2531450

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Required Intervention