FDA Adverse Event Injury Summary report: N

APEX HOLE ELIM POSITIVE STOP

MDR report key: 3251993 · Received July 29, 2013

Report

Report Number
1818910-2013-22339
Event Type
Injury
Date Received
July 29, 2013
Date of Event
June 6, 2013
Report Date
July 17, 2013
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
PMA / PMN Number
PK963309
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

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

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 LOT CODES 2140494, 2153536, AY8FW1000, AF9C91000, AY8FW1000 AND AF2FB4000. A SEARCH OF THE COMPLAINT DATABASE FINDS ADDITIONAL REPORTED INCIDENTS AGAINST LOT CODE A1NAF1000 SINCE ITS RELEASE FOR DISTRIBUTION; HOWEVER, A REVIEW OF THE DEVICE HISTORY RECORDS DID NOT REVEAL ANY RELATED MANUFACTURING ANOMALIES. 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. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

UDI: (B)(4).

Description of Event or Problem · 1

LITIGATION ALLEGES THAT THE PATIENT SUFFERS FROM PAIN, DISCOMFORT, INFLAMMATION, INFECTION AND DIFFICULTY AMBULATING. **UPDATE** (B)(4) 2013- PFS AND MEDICAL RECORDS RECEIVED. DUE TO LITIGATION ALLEGING INFECTION, ALL PRODUCTS HAVE BEEN REPORTED. THERE IS NO NEW ADDITIONAL INFORMATION THAT WOULD AFFECT THE EXISTING MDR DECISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
352439 APEX HOLE ELIM POSITIVE STOP HOLE ELIMINATOR LPH DEPUY ORTHOPAEDICS INC US A1NAF1000

Patients

Seq Age Sex Outcome Treatment
1 70 YR Other