BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 4192342 · Received October 22, 2014

    Report

    Report Number
    3010536692-2014-01510
    Event Type
    Injury
    Date Received
    October 22, 2014
    Date of Event
    October 7, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ALLEGEDLY THE PATIENT WAS REVISED FOR ELEVATED METAL ION VALUE IN THE BLOOD AT ROUTINE MEDICAL CHECKUP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    673902 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 107472436

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Required Intervention