BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CORAIL STEM DAR12 HAC

    MDR report key: 727574 · Received July 29, 2005

    Report

    Report Number
    1818910-2005-01217
    Event Type
    Malfunction
    Date Received
    July 29, 2005
    Date of Event
    June 24, 2005
    Report Date
    July 21, 2005
    Manufacturer
    DEPUY FRANCE S.A.
    Product Code
    LPH
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    INVALID DATA

    Narratives

    Additional Manufacturer Narrative · 1

    THIS COMPLAINT IS STILL UNDER INVESTIGATION.

    Description of Event or Problem · 1

    THE PATIENT WAS REVISED DUE TO THE STEM BREAKING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORAIL STEM DAR12 HAC TOTAL HIP PROTHESIS LPH DEPUY FRANCE S.A. NA 02274

    Patients

    Seq Age Sex Outcome Treatment
    1 NA