FDA Adverse Event Injury Summary report: N

PINN CAN BONE SCREW 6.5MMX25MM

MDR report key: 6043724 · Received October 20, 2016

Report

Report Number
1818910-2016-29721
Event Type
Injury
Date Received
October 20, 2016
Date of Event
October 12, 2016
Report Date
October 12, 2016
Manufacturer
JOHNSON & JOHNSON MEDICAL (SUZHOU) LTD.3006356043
Product Code
LPH
PMA / PMN Number
K983014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION OF THE REPORTED DEVICES WAS NOT POSSIBLE AS THEY WERE NOT RETURNED. A SEARCH OF THE COMPLAINTS DATABASES FINDS NO OTHER REPORTS AGAINST THE PRODUCT AND LOT CODE COMBINATIONS SINCE THEIR RELEASE TO DISTRIBUTION. THE INVESTIGATION CAN DRAW NO CONCLUSION WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION HAS NOT BEEN INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. (B)(4).

Description of Event or Problem · 1

PATIENT WAS REVISED DUE TO PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
695983 PINN CAN BONE SCREW 6.5MMX25MM HIP OTHER IMPLANT LPH JOHNSON & JOHNSON MEDICAL (SUZHOU) LTD.3006356043 D14060302

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention