BEUDAMED
    FDA Adverse Event Other Summary report: N

    DE PUY

    MDR report key: 21111 · Received February 9, 1994

    Report

    Report Number
    21111
    Event Type
    Other
    Date Received
    February 9, 1994
    Date of Event
    November 2, 1993
    Report Date
    December 26, 1993
    Manufacturer
    DE PUY, INC.
    Product Code
    JDO
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    IMPLANTATION PERFORMED 9/21/93 DUE TO SEVERE DEGENERATIVE CHANGES & PAIN IN RIGHT HIP. WOUND HEMATOMA EVAUCATED 1 WK POST THR. DISCHARGED FOR APPROXIMATELY 10 DAYS, RETURNEING WITH FEBER OF 100.8 & RIGHT THIGH PAIN. IMPLANT WAS SURGICALLY REMOVED & REPLACED ON 11/2/93.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DE PUY Implant TOTAL HIP PROSTHETIC JDO DE PUY, INC. SEE ATTACHED 3 RD PAGE

    Patients

    Seq Age Sex Outcome Treatment
    1 74 * Other