BEUDAMED
    FDA Adverse Event Injury Summary report: N

    28ID ENDURON +4 LINER GP

    MDR report key: 607665 · Received May 26, 2005

    Report

    Report Number
    1818910-2005-00792
    Event Type
    Injury
    Date Received
    May 26, 2005
    Date of Event
    May 25, 2005
    Report Date
    May 25, 2005
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    KWB
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PT WAS REVISED DUE TO POY WEAR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 28ID ENDURON +4 LINER GP TOTAL HIP REPLACEMENT KWB DEPUY ORTHOPAEDICS, INC. NA RG3A71003

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Required Intervention