FDA Adverse Event Injury Summary report: N

COCR FEMORAL BALL HEAD

MDR report key: 22573682 · Received July 23, 2025

Report

Report Number
3005180920-2025-00699
Event Type
Injury
Date Received
July 23, 2025
Date of Event
July 8, 2025
Report Date
July 22, 2025
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
JDI
UDI-DI
07630030805219
PMA / PMN Number
K080885
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

BATCH REVIEW PERFORMED ON 11-JUL-2025. BALL HEADS: COCR 01.25.031 COCR BALL HEAD 12/14 Ø36 MM SIZE M (K080885) LOT. 186285B: 1 ITEMS MANUFACTURED AND RELEASED ON 28-NOV-2023. EXPIRATION DATE: 14-APR-2029. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, ALL ITEMS OF THE SAME LOT HAVE BEEN SOLD WITH NO SIMILAR REPORTED EVENT DURING THE PERIOD OF REVIEW.

Description of Event or Problem · 0

AT ABOUT 3 MONTHS FROM THE PRIMARY SURGERY, THE PATIENT CAME IN REPORTING PAIN DUE TO A DISLOCATION OF THE MEDACTA HEAD FROM THE COMPETITOR LINER. THE SURGEON REVISED AND UPSIZED ONLY THE HEAD TO GIVE THE PATIENT STABILITY TO DETER RECURRING DISLOCATIONS. THE SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1736935 COCR FEMORAL BALL HEAD COCR BALL HEAD 12/14 Ø36 MM SIZE M JDI MEDACTA INTERNATIONAL SA 01.25.031 186285B 07630030805219

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention