BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PROFEMUR(R) MODULAR FEMORAL NECK

    MDR report key: 3844066 · Received June 2, 2014

    Report

    Report Number
    3010536692-2014-00877
    Event Type
    Injury
    Date Received
    June 2, 2014
    Date of Event
    March 24, 2014
    Report Date
    May 15, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    LWJ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    INVESTIGATION IS NOT COMPLETE. REPORT WILL BE UPDATED.

    Description of Event or Problem · 1

    ALLEGEDLY THE PATIENT WAS REVISED DUE TO AN ALLEGED NECK FRACTURE THAT OCCURRED WHILE THE PATIENT WAS AT WORK (LEFT).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    322344 PROFEMUR(R) MODULAR FEMORAL NECK HIP COMPONENT LWJ MICROPORT ORTHOPEDICS INC. 075235988

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Required Intervention