BEUDAMED
    FDA Adverse Event Other Summary report: N

    FOUNDATION HIP SYSTEM

    MDR report key: 918294 · Received September 21, 2007

    Report

    Report Number
    1644408-2007-00186
    Event Type
    Other
    Date Received
    September 21, 2007
    Date of Event
    September 6, 2007
    Report Date
    September 21, 2007
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    KWY
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    PT FELL AND FRACTURED FEMURE AROUND STEM. STEM REMOVED AND REPLACED WITH CEMENTED STEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOUNDATION HIP SYSTEM HIP STEM KWY ENCORE MEDICAL, L.P. 959181

    Patients

    Seq Age Sex Outcome Treatment
    1 93 YR Required Intervention