FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY SZ 4 LT CR FEMUR

MDR report key: 2955191 · Received February 11, 2013

Report

Report Number
1818910-2013-12132
Event Type
Injury
Date Received
February 11, 2013
Date of Event
January 28, 2013
Report Date
January 28, 2013
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A LOT SPECIFIC COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT CODE AND LOT CODE REQUIRED WAS NOT PROVIDED. REQUESTS FOR ADDITIONAL INVESTIGATIONAL INPUTS WERE MADE; HOWEVER, 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.

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.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS PAIN. LOOSENING WAS SUSPECTED, BUT NO LOOSENING WAS FOUND.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
59735 UNKNOWN DEPUY SZ 4 LT CR FEMUR FEMORAL KNEE PROSTHESIS JWH DEPUY ORTHOPAEDICS, INC. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 71 YR Required Intervention