FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY HIP COMPONENT

MDR report key: 645100 · Received November 8, 2005

Report

Report Number
1818910-2005-02195
Event Type
Injury
Date Received
November 8, 2005
Date of Event
October 13, 2005
Report Date
October 13, 2005
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
JDI
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

LEGAL PAPERS STATE THE PLAINTIFF WAS IMPLANTED ON OCT 17, 2002 AND HAS SUFFERED PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY HIP COMPONENT TOTAL HIP PROSTHESIS JDI DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention