BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEPUY ROT. PLAT. CURVED TIBIAL INSERT

    MDR report key: 2113357 · Received May 27, 2011

    Report

    Report Number
    MW5020829
    Event Type
    Injury
    Date Received
    May 27, 2011
    Date of Event
    May 9, 2011
    Report Date
    May 27, 2011
    Manufacturer
    DEPUY ORTHOPAEDICS INC.
    Product Code
    JDI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ACETABULAR FRACTURE NON UNION AND FAILED LEFT TOTAL HIP ARTHROPLASTY. THE ACETABULAR COMPONENT OF THE PROSTHESIS MIGRATED, CAUSING A FAILURE OF THE REPAIR AND NECESSITATING A SECOND OPERATIVE PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DEPUY ROT. PLAT. CURVED TIBIAL INSERT HIP PROSTHETIC JDI DEPUY ORTHOPAEDICS INC. 2704858
    2 DEPUY 3-POST ROUND DOME PATELLA HIP PROSTHETIC JDI DEPUY ORTHOPAEDICS INC. 2837839

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Hospitalization