FDA Adverse Event Injury Summary report: N

PROFEMUR(R) RAZ STEM

MDR report key: 3167225 · Received June 13, 2013

Report

Report Number
1043534-2013-00988
Event Type
Injury
Date Received
June 13, 2013
Date of Event
October 25, 2012
Report Date
May 8, 2013
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
KWA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: NO CONCLUSION CAN BE DRAWN. THE COMPLAINT WAS REVIEWED AND ANALYSIS SHOWED NO TREND FOR ITEM/LOT. THE PACKAGE INSERT WAS ALSO REVIEWED. THE PRODUCT WAS NOT RETURNED.(B)(4).

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 IS THE SAME EVENT AS 1043534-2013-00985, 00986, 00987.

Description of Event or Problem · 1

ALLEGEDLY REVISED DUE TO MOM COMPLICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
268051 PROFEMUR(R) RAZ STEM HIP COMPONENT, CODE:KWA KWA WRIGHT MEDICAL TECHNOLOGY, INC. 067423523

Patients

Seq Age Sex Outcome Treatment
1 44 YR Required Intervention