BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PINNACLE CUP

    MDR report key: 2132691 · Received June 10, 2011

    Report

    Report Number
    MW5021004
    Event Type
    Injury
    Date Received
    June 10, 2011
    Date of Event
    June 2, 2011
    Report Date
    June 10, 2011
    Manufacturer
    DEPUY
    Product Code
    KWA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    REMOVAL OF A DEPUY PINNACLE CUP, LINER, AND SUMMIT STEM 3 YEARS AFTER IMPLANTATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PINNACLE CUP CUP KWA DEPUY
    2 PINNACLE LINER LINER KWA DEPUY
    3 PINNACLE SUMMIT STEM STEM LPH DEPUY

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Hospitalization