BEUDAMED
    FDA Adverse Event Other Summary report: N

    UNKNOWN HIP

    MDR report key: 2093702 · Received April 21, 2011

    Report

    Report Number
    1644408-2011-00227
    Event Type
    Other
    Date Received
    April 21, 2011
    Date of Event
    April 14, 2011
    Report Date
    April 14, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - DUE TO DISLOCATION. THE SURGEON CHANGED THE CUP, STEM WELL FIXED (LEFT REVELATION HIP).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN HIP UNKNOWN LPH ENCORE MEDICAL, L.P. NA

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Required Intervention