FDA Adverse Event Injury Summary report: N

1043534-2012-01178

MDR report key: 2754851 · Received September 21, 2012

Report

Report Number
1043534-2012-01178
Event Type
Injury
Date Received
September 21, 2012
Date of Event
September 8, 2010
Report Date
September 19, 2012
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
MRA
PMA / PMN Number
P030027
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: NO CONCLUSION CAN BE DRAWN.

Additional Manufacturer Narrative · 1

PER FDA, REOPENED FILE AS A REPORTABLE MALFUNCTION IN ORDER TO REPORT AS PART OF A RETROSPECTIVE REVIEW OF CERAMIC HEADS. THIS IS THE SAME EVENT AS 1043534-2012-01179.

Description of Event or Problem · 1

ALLEGEDLY, PATIENT SUFFERED A FAILURE OF THE ACETABULAR LINER BY FRACTURING INTO MULTIPLE PIECES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MRA WRIGHT MEDICAL TECHNOLOGY, INC.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention