FDA Adverse Event
Injury
Summary report: N
UNKNOWN DEPUY ASR FEMORAL HEAD
MDR report key: 2990110
·
Received March 5, 2013
Report
- Report Number
- 1818910-2013-02738
- Event Type
- Injury
- Date Received
- March 5, 2013
- Date of Event
- March 7, 2006
- Report Date
- February 25, 2013
- Manufacturer
- DEPUY INTERNATIONAL
- Product Code
- KXA
- Removal / Correction Number
- Z-1749/1816-2011
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OR, US
- Reporter Occupation
- ATTORNEY
Narratives
Additional Manufacturer Narrative · 1
THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN (B)(4) 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.
Description of Event or Problem · 1
LITIGATION ALLEGED THE PATIENT SUFFERED PERMANENT DISABILITY, DECREASED MOBILITY, CONSTANT PAIN, PHYSICAL DISFIGUREMENT, AND OTHER INJURIES DUE TO EXCESSIVE LEVELS OF CHROMIUM AND COBALT IN HER BLOOD STREAM AS A RESULT OF THE IMPLANTED ASR HIP.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 93271 | UNKNOWN DEPUY ASR FEMORAL HEAD | FEMORAL HEAD HIP IMPLANT | KXA | DEPUY INTERNATIONAL | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 55 YR | Required Intervention |