BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALTRX NEUT 36IDX52OD

    MDR report key: 7074361 · Received December 1, 2017

    Report

    Report Number
    1818910-2017-50471
    Event Type
    Injury
    Date Received
    December 1, 2017
    Date of Event
    November 1, 2017
    Report Date
    November 2, 2017
    Manufacturer
    DEPUY IRELAND 961610 
    Product Code
    LPH
    UDI-DI
    10603295016328
    PMA / PMN Number
    K102423
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    HEALTH PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    PRODUCT COMPLAINT: (B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. DEPUY CONSIDERS THE INVESTIGATION CLOSED. 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 WILL BE FILED AS APPROPRIATE.

    Additional Manufacturer Narrative · 1

    PRODUCT COMPLAINT # ==> (B)(4). 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

    REMOVED HEAD AND POLY DUE TO INFECTION. PATIENT CONSEQUENCE? :UNKNOWN. IS THE INFORMATION BEING SUBMITTED FOR THIS COMPLAINT ALL THE DETAILS THAT ARE KNOWN/AVAILABLE REGARDING THIS EVENT? : YES

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    856451 ALTRX NEUT 36IDX52OD HIP ACETABULAR LINER LPH DEPUY IRELAND 961610  HD8162 10603295016328

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Required Intervention