FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY ASR FEMORAL HEAD

MDR report key: 2801856 · Received October 23, 2012

Report

Report Number
1818910-2012-23843
Event Type
Injury
Date Received
October 23, 2012
Report Date
August 15, 2012
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z- 1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN AUGUST 2010, AND THE ASR PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INVESTIGATION OF THIS INDIVIDUAL INCIDENT WILL NOT BE UNDERTAKEN, AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. (B)(4). DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

LITIGATION PAPERS ALLEGE THE PATIENT SUFFERS FROM PAIN, ELEVATED METAL ION LEVELS, DISFIGUREMENT, PHYSICAL IMPAIRMENT AND EMOTIONAL STRESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY ASR FEMORAL HEAD ASR TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other