BEUDAMED
    FDA Adverse Event Injury Summary report: N

    M/H INTERLOK (NTS)

    MDR report key: 356545 · Received October 16, 2001

    Report

    Report Number
    1825034-2001-00095
    Event Type
    Injury
    Date Received
    October 16, 2001
    Date of Event
    September 13, 1999
    Report Date
    October 15, 2001
    Manufacturer
    BIOMET, INC.
    Product Code
    JDT
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    TOTAL HIP ARTHROPLASTY PERFORMED IN 1992. REVISION PERFORMED IN 1999, DUE TO FRACTURE OF FEMORAL STEM COMPONENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    46305 M/H INTERLOK (NTS) PROSTHESIS, HIP, COMP. JDT BIOMET, INC. NA 436820

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Hospitalization| R