FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 28 +1.5 GR

MDR report key: 2112615 · Received May 19, 2011

Report

Report Number
1818910-2011-08838
Event Type
Injury
Date Received
May 19, 2011
Date of Event
April 19, 2011
Report Date
April 19, 2011
Manufacturer
JOHNSON & JOHNSON MEDICAL (DEPUY - SUZHOU) LTD.
Product Code
JDI
PMA / PMN Number
K883460
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER

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.

Additional Manufacturer Narrative · 1

THE PRODUCTS ASSOCIATED WITH THIS REPORTED EVENT WERE NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE DID NOT SHOW ANY OTHER REPORTS AGAINST THE PROVIDED PRODUCT/LOT CODE COMBINATIONS. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE REPORTED EVENT WITH THE PROVIDED INFORMATION. NO EVIDENCE WAS FOUND SUGGESTING PRODUCT ERROR WAS A CONTRIBUTING FACTOR AND THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED.DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

PT WAS REVISED TO ADDRESS INSTABILITY AND DISLOCATION. IT WAS REPORTED THAT THE PT FELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICUL/EZE BALL 28 +1.5 GR 87JDI JDI JOHNSON & JOHNSON MEDICAL (DEPUY - SUZHOU) LTD. NA D10120227

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention