BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PROFEMUR MODULAR FEMORAL NECK

    MDR report key: 9756699 · Received February 26, 2020

    Report

    Report Number
    3010536692-2020-00150
    Event Type
    Injury
    Date Received
    February 26, 2020
    Date of Event
    January 18, 2020
    Report Date
    June 9, 2020
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    LWJ
    UDI-DI
    M684PHA012121
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ES
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    THIS EVENT WILL BE UPDATED ONCE THE INVESTIGATION IS COMPLETE. TRENDS WILL BE EVALUATED.

    Description of Event or Problem · 1

    ALLEGEDLY, THE PATIENT WENT TO EMERGENCY DUE TO A HIP DISLOCATION. THE X RAYS SHOWED THE FRACTURE NECK. AEMPS: PS/MRG/58073.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    221045 PROFEMUR MODULAR FEMORAL NECK HIP COMPONENT LWJ MICROPORT ORTHOPEDICS INC. PHA01212 1579913 M684PHA012121

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention