FDA Adverse Event Injury Summary report: N

ASR ACETABULAR IMPLANT 62

MDR report key: 2962380 · Received February 14, 2013

Report

Report Number
1818910-2013-02516
Event Type
Injury
Date Received
February 14, 2013
Date of Event
April 21, 2008
Report Date
July 20, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

DEPUY STILL CONSIDERS THE INVESTIGATION CLOSED.

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 HIP RESURFACING - LEFT HIP; REASON FOR REVISION: PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
65664 ASR ACETABULAR IMPLANT 62 ASR TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL 2281761

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention