FDA Adverse Event Injury Summary report: N

ARTICULEZE M HEAD 36MM +1.5

MDR report key: 2761310 · Received September 26, 2012

Report

Report Number
1818910-2012-21971
Event Type
Injury
Date Received
September 26, 2012
Date of Event
March 4, 2005
Report Date
August 31, 2012
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
JDI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT AND LOT CODE REQUIRED WAS NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS REGARDING THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INABILITY TO IDENTIFY A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ANY ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

LITIGATION ALLEGES PATIENT EXPERIENCED SEVERE PAIN AND DISCOMFORT, A HIP DISLOCATION, AND DIFFICULTY WALKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARTICULEZE M HEAD 36MM +1.5 ARTICULEZE HEAD (12/14 TAPER) : HIP METAL FEMORAL HEADS JDI DEPUY ORTHOPAEDICS INC US 1130641

Patients

Seq Age Sex Outcome Treatment
1 53 YR Death| R