BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ANCA FIT LINER

    MDR report key: 9664361 · Received February 4, 2020

    Report

    Report Number
    3010536692-2019-01084
    Event Type
    Injury
    Date Received
    February 4, 2020
    Report Date
    October 9, 2019
    Manufacturer
    HRY
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    THE DEVICE INVOLVED IS NOT REPORTABLE. PLEASE VOID THIS REPORT.

    Description of Event or Problem · 1

    ALLEGEDLY ATTENDED REVISION OF AN ANCA FIT HIP IMPLANTED 10+ YEARS AGO. SURGEON USED LONG AR15 NECK WITH BLOBALL HEAD AND STRYKER CUP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    130126 ANCA FIT LINER LINER LPH HRY NI

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Required Intervention