FDA Adverse Event Malfunction Summary report: N

1043534-2012-01060

MDR report key: 2755898 · Received September 24, 2012

Report

Report Number
1043534-2012-01060
Event Type
Malfunction
Date Received
September 24, 2012
Date of Event
January 25, 2006
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
MRA
PMA / PMN Number
P030027
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DURING A RETROSPECTIVE REVIEW, THIS WAS DETERMINED TO BE A REPORTABLE MALFUNCTION. THIS IS THE SAME EVENT AS 1043534-2012-01148.

Description of Event or Problem · 1

FRACTURED FEMORAL HEAD IMPLANT. ALLEGEDLY LINER FRACTURED DURING REMOVAL.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 22 YR