FDA Adverse Event Other Summary report: N

BIOPLEX C IMPLANT

MDR report key: 589899 · Received April 6, 2005

Report

Report Number
2029012-2005-00012
Event Type
Other
Date Received
April 6, 2005
Date of Event
January 10, 2005
Report Date
March 29, 2005
Manufacturer
INTERPORE CROSS INTL.
Product Code
JDK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

SURGEON REPORTED THAT THE IMPLANT CRACKED DURING SURGERY, HOWEVER THE IMPLANT DID NOT BREAK APART. NOTE: THE SURGEON OPTED TO LEAVE THE IMPLANT IN THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOPLEX C IMPLANT CEMENT RESTRICTOR JDK INTERPORE CROSS INTL. NA 405811/405312

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other