BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK HYL HIP LNR

    MDR report key: 478881 · Received August 20, 2003

    Report

    Report Number
    1818910-2003-00533
    Event Type
    Injury
    Date Received
    August 20, 2003
    Date of Event
    February 10, 2003
    Report Date
    July 22, 2003
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    JWH
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    THE PATIENT WS REVISED FOR POLY WEAR AND CONTINUES TO BE DISABLED WITH BLOOD CLOTS SINCE THE SURGERY. PATIENT SUFFERS FROM AVASCULAR NECROSIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK HYL HIP LNR TOTAL HIP PROSTHESIS JWH DEPUY ORTHOPAEDICS, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention