FDA Adverse Event Injury Summary report: N

ASR ACETABULAR IMPLANT 48

MDR report key: 2973725 · Received February 22, 2013

Report

Report Number
1818910-2013-02608
Event Type
Injury
Date Received
February 22, 2013
Date of Event
September 25, 2012
Report Date
February 15, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PATIENT

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.THE CORRECTION/REMOVAL REPORTING NUMBER LISTED APPLIES TO THE CORRESPONDING PRODUCT CODE SOLD DOMESTICALLY.

Description of Event or Problem · 1

ASR REVISION;ASR XL - RIGHT HIP;REASON(S) FOR REVISION: NOISE, PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
78846 ASR ACETABULAR IMPLANT 48 ASR TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL 2323285

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention