FDA Adverse Event Death Summary report: N

UNKNOWN DEPUY ASR FEMORAL HEAD

MDR report key: 2864345 · Received December 10, 2012

Report

Report Number
1818910-2012-25493
Event Type
Death
Date Received
December 10, 2012
Report Date
November 21, 2012
Manufacturer
DEPUY INTERNATIONAL
Product Code
KXA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS CONSIDERED CLOSED.

Additional Manufacturer Narrative · 1

EXAMINATION OF THE REPORTED DEVICES WAS NOT POSSIBLE AS THEY WERE NOT RETURNED. A SEARCH OF THE COMPLAINTS DATABASES AND/OR A REVIEW OF DEVICE HISTORY RECORDS WERE NOT POSSIBLE AS THE REQUIRED PRODUCT/LOT CODE COMBINATIONS WERE NOT PROVIDED. THE INVESTIGATION CAN DRAW NO CONCLUSIONS WITH THE INFORMATION PROVIDED. ALTHOUGH ROOT CAUSE CANNOT BE DETERMINED, IT IS KNOWN 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.

Additional Manufacturer Narrative · 1

ALTHOUGH WRONGFUL DEATH IS CLAIMED IN THE LITIGATION, NO INFORMATION REGARDING THE DEATH WAS PROVIDED 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. NOT RECEIVED.

Description of Event or Problem · 1

LITIGATION PAPERS ALLEGE THE PATIENT SUFFERED PAIN AND WRONGFUL DEATH.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Death