FDA Adverse Event Injury Summary report: N

ARTICUL/EZE BALL 28 +5 BR

MDR report key: 23204102 · Received October 2, 2025

Report

Report Number
1818910-2025-17018
Event Type
Injury
Date Received
October 2, 2025
Date of Event
September 14, 2025
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
JDI
PMA / PMN Number
K883460
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. A SEARCH OF THE MEDTECH ORTHOPEDICS NONCONFORMANCE (NC) QUALITY SYSTEM FOUND NO NC¿S ASSOCIATED WITH THIS PRODUCT<136512000>/LOT<D21060460> COMBINATION. AS PART OF OUR COMPANY QUALITY SYSTEM PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND DISTRIBUTED TO APPROVED SPECIFICATIONS. ADDITIONAL COMPLAINT INFORMATION MONITORING FOR POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AS PART OF THE POST-MARKET SURVEILLANCE. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE HISTORY LOT: A SEARCH OF THE MEDTECH ORTHOPEDICS NONCONFORMANCE (NC) QUALITY SYSTEM FOUND NO NC¿S ASSOCIATED WITH THIS PRODUCT<136512000>/LOT<D21060460> COMBINATION. H11 ADDITIONAL NARRATIVE: ADDED: D10.

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). DEPUY SYNTHES IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH DEPUY SYNTHES HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, DEPUY SYNTHES OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF THE INFORMATION IS UNKNOWN, NOT AVAILABLE OR DOES NOT APPLY, THE SECTION/FIELD OF THE FORM IS LEFT BLANK.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT'S HIP STARTED TO DRAIN AFTER HAVING A HEMI HIP DONE ON (B)(6)2025. SURGEON WAS CONCERNED JOINT WAS INFECTED. WANTED TO DO AN EXCHANGE OF THE BIPOLAR AND 28 MM HEAD ALONG WITH A WASHOUT. DOI- (B)(6). DOJ- (B)(6)2025. AFFECTED SIDE-LEFT KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
318085 ARTICUL/EZE BALL 28 +5 BR ARTICULEZE HEAD (12/14 TAPER) : HIP METAL FEMORAL HEADS JDI DEPUY ORTHOPAEDICS INC US D21060460

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention