FDA Adverse Event Injury Summary report: N

CORAIL 2 STD SIZE 11

MDR report key: 2904262 · Received January 9, 2013

Report

Report Number
1818910-2013-00156
Event Type
Injury
Date Received
January 9, 2013
Date of Event
February 23, 2011
Report Date
February 3, 2013
Manufacturer
DEPUY FRANCE
Product Code
MEH
PMA / PMN Number
K042992
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(4).THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

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).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD A REVISION ON THE LEFT HIP IMPLANT. THE REASON FOR THE REVISION IS UNKNOWN.

Description of Event or Problem · 1

RIGHT HIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
11701 CORAIL 2 STD SIZE 11 HIP STEM MEH DEPUY FRANCE 2357646

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention