FDA Adverse Event Injury Summary report: N

TOTAL ASR FEM IMP SIZE 51

MDR report key: 3120771 · Received May 20, 2013

Report

Report Number
1818910-2013-05852
Event Type
Injury
Date Received
May 20, 2013
Date of Event
April 24, 2013
Report Date
May 20, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KXA
Removal / Correction Number
Z- 1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PATIENT

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. THE CORRECTION/REMOVAL REPORTING NUMBER LISTED APPLIES TO THE CORRESPONDING PRODUCT CODE SOLD DOMESTICALLY.

Additional Manufacturer Narrative · 1

DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

ASR REVISION; ASR RESURFACING RIGHT; REASON(S) FOR REVISION: PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
222653 TOTAL ASR FEM IMP SIZE 51 ASR TOTAL HIP REPLACEMENT KXA DEPUY INTERNATIONAL 2435042

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention