BEUDAMED
    FDA Adverse Event Other Summary report: N

    X-ALT HIP

    MDR report key: 2163615 · Received June 8, 2011

    Report

    Report Number
    1644408-2011-00326
    Event Type
    Other
    Date Received
    June 8, 2011
    Date of Event
    June 1, 2011
    Report Date
    June 1, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    LPH
    PMA / PMN Number
    K072154
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE LINER DID NOT SECURELY LOCK IN WITH THE 60MM MP10 SHELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 X-ALT HIP LINER/10 DEGREE HOODED - NEUTRAL LPH ENCORE MEDICAL, L.P. 53957746

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Required Intervention