BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOD ENHCD INS 28/57 APR

    MDR report key: 440690 · Received January 31, 2003

    Report

    Report Number
    440690
    Event Type
    Injury
    Date Received
    January 31, 2003
    Date of Event
    January 6, 2003
    Report Date
    January 19, 2003
    Manufacturer
    CENTERPLUS ORTHOPEDICS, INC
    Product Code
    KWB
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    REVISION OF TOTAL HIP ARTHOPLASTY RIGHT HIP. PAIN AND RECURRENT DISLOCATIONS AFTER A MOTOR VEHICLE ACCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOD ENHCD INS 28/57 APR HIP PROSTHESIS KWB CENTERPLUS ORTHOPEDICS, INC NA 1179172

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Hospitalization| R 4310-02-057 APR II 12 SLOT SHELL 57M LOT #194425| 2003, 5142 CERAMIC HEAD 2003, 2 SCREWS.