BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK HYL HIP LNR

    MDR report key: 482282 · Received September 9, 2003

    Report

    Report Number
    1818910-2003-00609
    Event Type
    Injury
    Date Received
    September 9, 2003
    Date of Event
    January 24, 2002
    Report Date
    August 14, 2003
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    JDI
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    PT WAS REVISED DUE TO COMPLETE DISINTEGRATION OF THE HIP LINER.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention