FDA Adverse Event Injury Summary report: N

GLOBAL ADVANTAGE ECC HD 44X18

MDR report key: 2082898 · Received May 3, 2011

Report

Report Number
1818910-2011-07752
Event Type
Injury
Date Received
May 3, 2011
Date of Event
April 5, 2011
Report Date
April 5, 2011
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
KWS
PMA / PMN Number
K992065
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE FOUND NO PRIOR REPORTS FOR BOTH OF THE REPORTED PART AND LOT NUMBER COMBINATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFO PROVIDED. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ANY ADD'L INFO BE REC'D TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

PT REVISED FOR POSTERIOR DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GLOBAL ADVANTAGE ECC HD 44X18 87 KWS, HSD KWS DEPUY ORTHOPAEDICS, INC. NA C3BJ31000

Patients

Seq Age Sex Outcome Treatment
1 68 YR Required Intervention