FDA Adverse Event Injury Summary report: N

PINNACLE MTL INS NEUT36IDX54OD

MDR report key: 3111448 · Received May 14, 2013

Report

Report Number
1818910-2013-17044
Event Type
Injury
Date Received
May 14, 2013
Date of Event
January 22, 2008
Report Date
May 8, 2013
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
KWA
PMA / PMN Number
PK003523
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE FOUND NO ADDITIONAL RELATED REPORTS FOR THE REPORTED PART AND LOT CODE COMBINATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS ONGOING. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Description of Event or Problem · 1

LITIGATION ALLEGES PAIN, DISCOMFORT AND SWELLING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
212334 PINNACLE MTL INS NEUT36IDX54OD METAL LINER KWA DEPUY ORTHOPAEDICS INC US 2132513

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention