FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUPS 46

MDR report key: 4090977 · Received September 16, 2014

Report

Report Number
1818910-2014-28075
Event Type
Injury
Date Received
September 16, 2014
Report Date
August 27, 2014
Manufacturer
DEPUY INTL., LTD. - 8010379
Product Code
KWA
PMA / PMN Number
PK040627
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL NARRATIVE:IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN AUGUST 2010, AND THE ASR PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INVESTIGATION OF THIS INDIVIDUAL INCIDENT WILL NOT BE UNDERTAKEN, AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. (B)(4). DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

LITIGATION PAPERS ALLEGE PAIN, INJURY TO THE BODY AND EXTREMITIES, AND EXCESSIVE METAL ION LEVELS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
570959 ASR ACETABULAR CUPS 46 HIP ACETABULAR CUP KWA DEPUY INTL., LTD. - 8010379 2139978

Patients

Seq Age Sex Outcome Treatment
1 Other