BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JOHNSON & JOHNSON

    MDR report key: 2861419 · Received December 3, 2012

    Report

    Report Number
    MW5027959
    Event Type
    Injury
    Date Received
    December 3, 2012
    Date of Event
    October 11, 2010
    Report Date
    November 7, 2012
    Manufacturer
    DEPUY INC., A JOHNSON & JOHNSON
    Product Code
    KWY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    MY EXPLANT COMPONENTS DO NOT MATCH MY HOSPITAL CHART STICKER INFO. THE (FEMORAL BALL HEAD) INFO ON EXPLANT: 32MM C 5MM EXT JJO (B)(4) DOES NOT MATCH SURGERY RECORDS FROM 1996 OR 2005. HAVE HAD 3 HIP REPLACEMENTS: (B)(6) 1996, (B)(6) 2005, AND (B)(6) 2010; ALL WHICH WERE DONE BY DR (B)(6). MY SECOND HIP (B)(6) 2005, FAILED PREMATURELY AND NEVER FELT RIGHT COMPARED TO THE 1ST AND 3RD. DR DISMISSED ME AS PT ARBITRARILY AND REFUSES TO PROVIDE ME OR MY NEW DOCTOR MY COMPLETE MEDICAL RECORDS NOR WILL HE EXPLAIN WHY THIS HAPPENED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JOHNSON & JOHNSON HIP HEAD KWY DEPUY INC., A JOHNSON & JOHNSON 55759
    2 DEPUY P.F.C. FEMORAL BALL HEAD / HIP HEAD KXA DEPUY ORTHOPAEDICS INC 1935139

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Hospitalization| R| S