BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PINN MAR NEUT 32IDX60OD

    MDR report key: 2122640 · Received June 3, 2011

    Report

    Report Number
    1818910-2011-09918
    Event Type
    Injury
    Date Received
    June 3, 2011
    Date of Event
    May 5, 2011
    Report Date
    May 5, 2011
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    LPH
    PMA / PMN Number
    K983014
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER
    Health Professional
    N

    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.

    Description of Event or Problem · 1

    PATIENT WAS REVISED TO ADDRESS POLY WEAR AND DISLOCATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PINN MAR NEUT 32IDX60OD 87LPH LPH DEPUY ORTHOPAEDICS, INC. NA W5KC81

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Male Required Intervention