FDA Adverse Event Injury Summary report: N

TOTAL ASR FEM IMP SIZE 47

MDR report key: 2872187 · Received December 13, 2012

Report

Report Number
1818910-2012-28608
Event Type
Injury
Date Received
December 13, 2012
Date of Event
March 23, 2010
Report Date
April 15, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KXA
Removal / Correction Number
Z- 1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

DEPUY STILL 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

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. THE CORRECTION/REMOVAL REPORTING NUMBER LISTED APPLIES TO THE CORRESPONDING PRODUCT CODE SOLD DOMESTICALLY.

Description of Event or Problem · 1

REASON(S) FOR REVISION: ACETABULAR CUP LOOSENING NOT THE FEMORAL HEAD

Description of Event or Problem · 1

ASR REVISION; ASR RESURFACING - RIGHT; REASON(S) FOR REVISION: UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TOTAL ASR FEM IMP SIZE 47 ASR TOTAL HIP REPLACEMENT KXA DEPUY INTERNATIONAL 1852118

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention