BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HIP REPLACEMENT SYSTEM

    MDR report key: 7237807 · Received February 1, 2018

    Report

    Report Number
    MW5075024
    Event Type
    Injury
    Date Received
    February 1, 2018
    Date of Event
    May 8, 2012
    Report Date
    January 31, 2018
    Manufacturer
    DEPUY
    Product Code
    JDI
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    I HAD A LEFT HIP REPLACEMENT WITH A DEPUY PRODUCT. THREE MODEL NUMBERS ARE LISTED. MODEL 1217-22-054, 1217-20-500 AND 1570-11-135. ALSO, 1221-36-054 AND 1365-52-000. AFTER SURGERY I EXPERIENCED A FRACTURE WHICH TOOK ME A YEAR TO RECOVER FROM. MY LEFT LEG IS AN INCH SHORTER NOW. I AM WRITING YOU TO LET YOU KNOW THAT MY LEFT HIP DOES, ON OCCASION, UNLOCK AND LOCK MY CAR AS I AM APPROACHING IT ON THE LEFT SIDE. HAS HAPPENED 15 TIMES OVER PAST 6 YEARS. I HAVE HAD WITNESSES. CAN YOU PLEASE INVESTIGATE AND REPLY. THANK YOU.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    77875 HIP REPLACEMENT SYSTEM HIP REPLACEMENT SYSTEM JDI DEPUY 1365-52-000

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Disability