FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUPS 56

MDR report key: 4222199 · Received November 3, 2014

Report

Report Number
1818910-2014-31036
Event Type
Injury
Date Received
November 3, 2014
Report Date
October 17, 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
NY, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

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. REF. (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. (B)(4).

Additional Manufacturer Narrative · 1

IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.DEPUY STILL CONSIDERS THE INVESTIGATION CLOSED.

Description of Event or Problem · 1

LITIGATION PAPERS ALLEGE PAIN, STIFFNESS, DISCOMFORT, WEAKNESS AND EXCESSIVE METAL ION LEVELS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
702815 ASR ACETABULAR CUPS 56 HIP ACETABULAR CUP KWA DEPUY INTL., LTD. - 8010379 2510501

Patients

Seq Age Sex Outcome Treatment
1 Other