FDA Adverse Event Malfunction Summary report: N

GLOBAL UNITE TR BODY SZ14 135

MDR report key: 7049863 · Received November 21, 2017

Report

Report Number
1818910-2017-29574
Event Type
Malfunction
Date Received
November 21, 2017
Date of Event
June 21, 2017
Report Date
June 21, 2017
Manufacturer
DEPUY IRELAND - 9616671
Product Code
LHX
UDI-DI
10603295416098
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # :(B)(4). INVESTIGATION SUMMARY : EXAMINATION OF THE RETURNED DEVICE CONFIRMED THE REPORTED EVENT. 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. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH , A FOLLOW-UP MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

SYNERGY STATES THAT THE GREEN COLOUR WAS LOOSE AND FELL APART BUT OUTSIDE THE PATIENT AND AFTER IT HAS BEEN USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
829785 GLOBAL UNITE TR BODY SZ14 135 MISC EXTREMITY INSTRUMENT/TRIAL LHX DEPUY IRELAND - 9616671 NW148537 10603295416098

Patients

Seq Age Sex Outcome Treatment
1