BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEPUY PINNACLE

    MDR report key: 3140852 · Received May 24, 2013

    Report

    Report Number
    MW5030349
    Event Type
    Injury
    Date Received
    May 24, 2013
    Date of Event
    March 26, 2013
    Report Date
    May 24, 2013
    Manufacturer
    DEPUY ORTHOPAEDICS
    Product Code
    KWA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    DEPUY PINNACLE MARATHON ACETABULAR LINER DISLOCATED FOR THE FOURTH TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    232659 DEPUY PINNACLE MARATHON ACETABULAR NEUT LINER 28 / 50MM OD KWA DEPUY ORTHOPAEDICS W5TB11036

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR Hospitalization| R