FDA Adverse Event Injury Summary report: N

LINEAGE(R) TRANSCEND(R) SUPERFINISHED FEMORAL HEAD

MDR report key: 2092015 · Received May 18, 2011

Report

Report Number
1043534-2011-00014
Event Type
Injury
Date Received
May 18, 2011
Date of Event
December 16, 2010
Report Date
December 22, 2010
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
JDL
PMA / PMN Number
K004043
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. TRENDS WILL BE EVALUATED. THE DEVICE EVENT CODE IS ADDRESSED IN THE PACKAGE INSERT. ALTHOUGH SEVERAL ATTEMPTS HAVE BEEN MADE, NO MEDWATCH 3500A HAS BEEN RECEIVED FROM THE USER FACILITY. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. (B)(4)

Additional Manufacturer Narrative · 1

CONCLUSION: PRODUCT DID NOT CONTRIBUTE TO EVENT. EVIDENCE PRODUCT WAS IN SPEC WHEN USED.

Description of Event or Problem · 1

ALLEGEDLY THE COMPONENT CAME OFF THE TRUNION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LINEAGE(R) TRANSCEND(R) SUPERFINISHED FEMORAL HEAD HIP COMPONENT JDL WRIGHT MEDICAL TECHNOLOGY, INC. 077455265

Patients

Seq Age Sex Outcome Treatment
1 71 YR Hospitalization| R