BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PERFECTA(R) SLT TAPER PS FLARE COLLARLESS STEM

    MDR report key: 2963344 · Received February 15, 2013

    Report

    Report Number
    1043534-2013-00284
    Event Type
    Injury
    Date Received
    February 15, 2013
    Date of Event
    May 25, 2012
    Report Date
    January 17, 2013
    Manufacturer
    WRIGHT MEDICAL TECHNOLOGY, INC.
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    CONCLUSION: NO CONCLUSION CAN BE DRAWN. THE COMPLAINT WAS REVIEWED AND ANALYSIS SHOWED NO TREND FOR ITEM/LOT. THE PACKAGE INSERT WAS ALSO REVIEWED. THE PRODUCT WAS NOT RETURNED. EVIDENCE THAT PRODUCT IN SPECIFICATION WHEN USED.

    Additional Manufacturer Narrative · 1

    THE INVESTIGATION IS NOT COMPLETE. TRENDS WILL BE EVALUATED. THE EVENT CODE IS ADDRESSED IN THE PACKAGE INSERT. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 1043534-2013-00282, 00283.

    Description of Event or Problem · 1

    ALLEGEDLY REVISED DUE TO MOM COMPLICATIONS. LEFT HIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    67498 PERFECTA(R) SLT TAPER PS FLARE COLLARLESS STEM HIP COMPONENT, CODE:JDI JDI WRIGHT MEDICAL TECHNOLOGY, INC. 124142855

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Required Intervention