FDA Adverse Event Injury Summary report: N

ASR ACETABULAR IMPLANT 50

MDR report key: 2920717 · Received January 17, 2013

Report

Report Number
1818910-2013-00440
Event Type
Injury
Date Received
January 17, 2013
Date of Event
December 4, 2006
Report Date
January 10, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
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

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. REF. (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

ASR REVISION, ASR XL - RIGHT, REASON FOR REVISION: UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
25837 ASR ACETABULAR IMPLANT 50 ASR TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL 1884527

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention