RESTORIS TOTAL HIP SYSTEM

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2013-07-18 for RESTORIS TOTAL HIP SYSTEM manufactured by Pipeline Orthopedics Llc.

Event Text Entries

[17929854] Incision and drainage procedure conducted on pt approximately one month after total hip arthroplasty surgery. Pt subsequently treated with antibiotics. No components replaced.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3009701876-2013-00012
MDR Report Key3251803
Report Source05
Date Received2013-07-18
Date of Report2013-07-18
Date of Event2013-06-20
Date Mfgr Received2013-06-20
Date Added to Maude2013-07-30
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 ContactSEAN LAVELLE
Manufacturer Street3 WING DR SUITE 102
Manufacturer CityCEDAR KNOLLS NJ 07927
Manufacturer CountryUS
Manufacturer Postal07927
Manufacturer Phone9732678800
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameRESTORIS TOTAL HIP SYSTEM
Generic NameOQH, LPH
Product CodeOQH
Date Received2013-07-18
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerPIPELINE ORTHOPEDICS LLC
Manufacturer AddressCEDAR KNOLLS NJ US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2013-07-18

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