FDA Adverse Event Injury Summary report: N

ASR ACETABULAR IMPLANT 46

MDR report key: 2243472 · Received September 12, 2011

Report

Report Number
1818910-2011-17594
Event Type
Injury
Date Received
September 12, 2011
Date of Event
June 14, 2011
Report Date
April 2, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PATIENT

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. THE CORRECTION/REMOVAL REPORTING NUMBER LISTED APPLIES TO THE CORRESPONDING PRODUCT CODE SOLD DOMESTICALLY. NOT RETURNED.

Additional Manufacturer Narrative · 1

DEPUY STILL CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Additional Manufacturer Narrative · 1

THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN AUGUST 2010, AND THE ASR PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INVESTIGATION OF THIS INDIVIDUAL INCIDENT WILL NOT BE UNDERTAKEN, AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. (B)(4).

Description of Event or Problem · 1

REASON FOR REVISION: ALVAL / SOFT TISSUE REACTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ASR ACETABULAR IMPLANT 46 ACETABULAR CUP IMPLANT KWA DEPUY INTERNATIONAL 1877476

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention