FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUP 52

MDR report key: 2972966 · Received February 21, 2013

Report

Report Number
1818910-2013-02903
Event Type
Injury
Date Received
February 21, 2013
Report Date
May 2, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
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. (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.

Additional Manufacturer Narrative · 1

**UPDATE** (B)(4) 2013 - ASR/SUPPLEMENTAL INFORMATION RECEIVED. PART/LOT AND DOR HAVE BEEN UPDATED. THERE IS NO NEW INFORMATION THAT WOULD CHANGE THE OUTCOME OF THE INVESTIGATION. DEPUY CONSIDERS THIS COMPLAINT CLOSED AT THIS TIME.

Description of Event or Problem · 1

LITIGATION ALLEGES PATIENT HAD PAIN AFTER ASR HIP IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
75819 ASR ACETABULAR CUP 52 TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL 2440048

Patients

Seq Age Sex Outcome Treatment
1 Other