FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY ASR FEMORAL HEAD

MDR report key: 3082765 · Received April 29, 2013

Report

Report Number
1818910-2013-05315
Event Type
Injury
Date Received
April 29, 2013
Date of Event
January 1, 2013
Report Date
April 17, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KXA
Removal / Correction Number
Z1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
ATTORNEY

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.

Description of Event or Problem · 1

LITIGATION ALLEGES PATIENT HAD PAIN, DISCOMFORT; AND BECAME INCREASINGLY PAINFUL TO WALK, DRIVE, MOVE LEGS, AND RISE FROM A SEATED POSITION AFTER ASR HIP IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
185534 UNKNOWN DEPUY ASR FEMORAL HEAD TOTAL HIP REPLACEMENT KXA DEPUY INTERNATIONAL UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention