FDA Adverse Event Injury Summary report: N

ALTEON HIP COMPONENTS

MDR report key: 24997839 · Received April 27, 2026

Report

Report Number
1038671-2026-00495
Event Type
Injury
Date Received
April 27, 2026
Report Date
April 27, 2026
Manufacturer
EXACTECH, INC.
Product Code
JDI
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

D10: 01-030-01-0450 - ALT CUP CLSTR G4 SZ 50: (B)(6), 170-36-03 - BIOLOX DELTA FEMORAL HEAD 36MM OD, +3.5MM: (B)(6), 188-01-03 - WEDGE PLASMA X/O SZ 3: (B)(6). THE REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. NO DEVICE WAS RETURNED FOR EVALUATION; FURTHER, PHOTOGRAPHS AND/OR RADIOGRAPH IMAGES WERE NOT PROVIDED FOR REVIEW. OPERATIVE NOTES AND/OR MEDICAL RECORDS WERE NOT PROVIDED FOR REVIEW OF USAGE/TECHNIQUE. A DEFINITIVE ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. IF ANY FURTHER INFORMATION IS OBTAINED THAT WOULD CHANGE OR ALTER ANY INFORMATION PROVIDED, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY.

Description of Event or Problem · 0

AS REPORTED, THE PATIENT UNDERWENT AN INITIAL TOTAL HIP ARTHROPLASTY. SUBSEQUENTLY, THE PATIENT DISLOCATED, EXPERIENCED PAIN, AND WENT TO THE EMERGENCY ROOM FOR REDUCTION. NO FURTHER INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
310680 ALTEON HIP COMPONENTS PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED JDI EXACTECH, INC.

Patients

Seq Age Sex Outcome Treatment
1 66 YR Female Hospitalization| R SEE H11