UNKNOWN DEPUY CEMENT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,08 report with the FDA on 2012-09-17 for UNKNOWN DEPUY CEMENT manufactured by .

Event Text Entries

[2880731] Patient was revised to address osteolysis, poly wear, and loosening of the femoral component at the bone/cement interface. Depuy cement was used at the time of implantation.
Patient Sequence No: 1, Text Type: D, B5


[10183049] This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed.
Patient Sequence No: 1, Text Type: N, H10


[10254983] The devices associated with this report were not returned. Review of the device history records and/or a complaint database search was not possible as the lot codes required were not provided. Requests for additional investigational inputs were made in accordance with wi-7915 appendix a; rev. C. No additional information was obtained. The investigation could not draw any conclusions regarding the reported event with the information available. Based on the inability to identify a root cause, the need for corrective action was not indicated. Depuy considers the investigation closed at this time. Should any additional information be received to change the outcome of the performed investigation, the complaint will be re-opened
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2012-20651
MDR Report Key2747120
Report Source05,08
Date Received2012-09-17
Date of Report2012-09-11
Date of Event2012-09-11
Date Mfgr Received2012-09-11
Date Added to Maude2012-09-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactDONALD DION JR.
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 465810988
Manufacturer CountryUS
Manufacturer Postal465810988
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN DEPUY CEMENT
Generic NameBONE CEMENT
Product CodeJDY
Date Received2012-09-17
Catalog NumberUNK
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2012-09-17

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