FDA Adverse Event Injury Summary report: N

PROFEMUR(R) Z STEM PLASMA SPRAYED

MDR report key: 2982540 · Received February 28, 2013

Report

Report Number
1043534-2013-00397
Event Type
Injury
Date Received
February 28, 2013
Date of Event
May 7, 2011
Report Date
January 29, 2013
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
KWA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, 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.(B)(4).

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 1043534-2013-00395, 00396, 00398.

Description of Event or Problem · 1

ALLEGEDLY REVISED DUE TO MOM COMPLICATIONS. RIGHT HIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
87120 PROFEMUR(R) Z STEM PLASMA SPRAYED HIP COMPONENT, CODE:KWA KWA WRIGHT MEDICAL TECHNOLOGY, INC. 11795689

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention