FDA Adverse Event
Injury
Summary report: N
UNKNOWN HIP
MDR report key: 4251019
·
Received November 14, 2014
Report
- Report Number
- 0001825034-2014-08627
- Event Type
- Injury
- Date Received
- November 14, 2014
- Report Date
- October 21, 2014
- Manufacturer
- BIOMET ORTHOPEDICS
- Product Code
- JDI
- PMA / PMN Number
- PUNKNOWN
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE PRODUCT IDENTIFICATION NECESSARY TO REVIEW MANUFACTURING HISTORY WAS NOT PROVIDED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. THE FOLLOWING SECTIONS COULD NOT BE COMPLETED WITH THE LIMITED INFORMATION PROVIDED. EXPIRATION DATE - UNKNOWN, DATE IMPLANTED - UNKNOWN, INITIAL REPORTER - UNKNOWN, PMA/510(K) NUMBER/ MANUFACTURE DATE ¿ UNKNOWN.
Description of Event or Problem · 1
IT WAS REPORTED PATIENT UNDERWENT A TOTAL HIP ARTHROPLASTY ON AN UNKNOWN DATE. A REVISION HAS BEEN INDICATED DUE TO AN UNKNOWN REASON; HOWEVER, NO REVISION HAS BEEN REPORTED TO DATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 737163 | UNKNOWN HIP | PROSTHESIS, HIP | JDI | BIOMET ORTHOPEDICS | N/A | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |