FDA Adverse Event Injury Summary report: N

PROFEMUR(R) MODULAR FEMORAL NECK

MDR report key: 3981138 · Received August 5, 2014

Report

Report Number
3010536692-2014-01022
Event Type
Injury
Date Received
August 5, 2014
Date of Event
May 28, 2014
Report Date
July 9, 2014
Manufacturer
MICROPORT ORTHOPEDICS INC.
Product Code
LWJ
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS NOT COMPLETE. TRENDS WILL BE EVALUATED. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. THIS EVENT OCCURRED IN (B)(6).

Description of Event or Problem · 1

ALLEGEDLY WHILST WALKING ON A STAIRCASE, THE PATIENT EXPERIENCED A SUDDEN WEAKNESS IN THE RIGHT LEG WHICH RESULTED IN A FALL. THE OUTCOME WAS A FRACTURE OF THE FEMORAL NECK WHICH NEEDED A STEM REPLACEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
456753 PROFEMUR(R) MODULAR FEMORAL NECK HIP COMPONENT LWJ MICROPORT ORTHOPEDICS INC. 089922078

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention