FDA Adverse Event Injury Summary report: N

PROFEMUR(R) Z STEM

MDR report key: 2991693 · Received March 6, 2013

Report

Report Number
1043534-2013-00464
Event Type
Injury
Date Received
March 6, 2013
Date of Event
September 22, 2011
Report Date
October 22, 2012
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
LPH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

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 EVENT OCCURRED IN (B)(6).

Additional Manufacturer Narrative · 1

CONCLUSION: NO CONCLUSION CAN BE DRAWN. THE COMPLAINT WAS REVIEWED. THE PRODUCT WAS NOT RETURNED. (B)(4).

Description of Event or Problem · 1

ALLEGEDLY REVISED DUE TO INFECTION. LEFT SIDE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
95844 PROFEMUR(R) Z STEM HIP COMPONENT, CODE:LPH LPH WRIGHT MEDICAL TECHNOLOGY, INC. NI

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention