FDA Adverse Event Injury Summary report: N

HUMELOCK REVERSED

MDR report key: 21397120 · Received February 18, 2025

Report

Report Number
3009532798-2025-00008
Event Type
Injury
Date Received
February 18, 2025
Date of Event
February 3, 2025
Report Date
February 17, 2025
Manufacturer
FX SHOULDER SOLUTIONS
Product Code
PHX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE EVENT TOOK PLACE OUTSIDE THE UNITED STATES (IN FRANCE) AND WAS ASSOCIATED WITH A PRODUCT THAT IS ALSO CLEARED FOR THE MARKET IN THE UNITED STATES.

Description of Event or Problem · 0

THE PATIENT WAS REVISED DUE TO AN INFECTION ON (B)(6) 2025. THE IMPLANTATION DATE UNKNOWN. A CUP WAS EXPLANTED. A CUP WAS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1179788 HUMELOCK REVERSED REVERSED SHOULDER PROSTHESIS PHX FX SHOULDER SOLUTIONS

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| H