FDA Adverse Event Injury Summary report: N

CONSERVE(R) TOTAL HEAD W/BFH

MDR report key: 2973088 · Received February 21, 2013

Report

Report Number
1043534-2013-00370
Event Type
Injury
Date Received
February 21, 2013
Date of Event
September 12, 2012
Report Date
January 24, 2013
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
JDL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: NO CONCLUSION CAN BE DRAWN.THE COMPLAINT AND PACKAGE INSERT WERE REVIEWED. THE PRODUCT WAS NOT RETURNED.EVIDENCE THAT PRODUCT IN SPECIFICATION WHEN USED.(B)(4).

Additional Manufacturer Narrative · 1

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 1043534-2013-00369, 00371, 00372.

Description of Event or Problem · 1

ALLEGEDLY REVISED DUE TO MOM COMPLICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
76432 CONSERVE(R) TOTAL HEAD W/BFH HIP COMPONENT, CODE:JDL JDL WRIGHT MEDICAL TECHNOLOGY, INC. 019769902

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention