BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 3252994 · Received July 29, 2013

    Report

    Report Number
    1043534-2013-01204
    Event Type
    Injury
    Date Received
    July 29, 2013
    Date of Event
    December 13, 2012
    Report Date
    June 28, 2013
    Manufacturer
    WRIGHT MEDICAL TECHNOLOGY, INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    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 1043534-2013-01203, 01205, 01206.

    Description of Event or Problem · 1

    ALLEGEDLY PATIENT WAS REVISED DUE MOM COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    352656 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT, CODE:JDL JDL WRIGHT MEDICAL TECHNOLOGY, INC. 108715115

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Required Intervention