FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY ASR FEMORAL HEAD

MDR report key: 2843920 · Received November 23, 2012

Report

Report Number
1818910-2012-24628
Event Type
Injury
Date Received
November 23, 2012
Report Date
August 23, 2012
Manufacturer
DEPUY INTERNATIONAL
Product Code
KXA
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 ALLEGED THE PATIENT SUFFERED PAIN, FATIGUE AND DECREASED MOBILITY AS A RESULT OF THE IMPLANTED ASR HIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY ASR FEMORAL HEAD FEMORAL HEAD HIP IMPLANT KXA DEPUY INTERNATIONAL NI

Patients

Seq Age Sex Outcome Treatment
1 Other