FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY SIGMA PS FEMUR

MDR report key: 2922651 · Received January 18, 2013

Report

Report Number
1818910-2013-11178
Event Type
Injury
Date Received
January 18, 2013
Date of Event
January 11, 2013
Report Date
January 11, 2013
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LPH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

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 DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT CODE AND LOT CODE REQUIRED WAS NOT PROVIDED. REQUESTS FOR ADDITIONAL INVESTIGATIONAL INPUTS WERE MADE IN ACCORDANCE WITH WI-7915 APPENDIX A; REV. C. NO ADDITIONAL INFORMATION WAS OBTAINED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS REGARDING THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INABILITY TO IDENTIFY A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
28317 UNKNOWN DEPUY SIGMA PS FEMUR FEMORAL KNEE PROSTHESIS LPH DEPUY ORTHOPAEDICS, INC. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 84 YR Required Intervention