BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN J & J LCS KNEE

    MDR report key: 669203 · Received January 27, 2006

    Report

    Report Number
    1818910-2006-00334
    Event Type
    Injury
    Date Received
    January 27, 2006
    Date of Event
    January 10, 2005
    Report Date
    December 16, 2005
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    JWH
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    LEGAL DEPARTMENT RECEIVED A PHONE CALL FROM THE PATIENT'S ATTORNEY ALLEGING THE PATIENT WAS REVISED. THE REASON FOR REVISION IS UNKNOWN. UPDATE: 12/16/2005 - LEGAL RECEIVED MEDICAL RECORDS INDICATING THAT THE PATIENT WAS REVISED IN 2005 DUE TO PAIN AND LOOSENING. IT IS UNKNOWN AT THIS TIME WHAT COMPONENT(S) WAS REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN J & J LCS KNEE TOTAL KNEE REPLACEMENT JWH DEPUY ORTHOPAEDICS, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Required Intervention