UNKNOWN DEPUY 41MM PATELLA UNK-KNEE

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 2013-10-18 for UNKNOWN DEPUY 41MM PATELLA UNK-KNEE manufactured by Depuy Orthopaedics Inc.

Event Text Entries

[3908963] Patient was revised to address infection.
Patient Sequence No: 1, Text Type: D, B5


[11117892] This complaint is still under investigation. Not returned.
Patient Sequence No: 1, Text Type: N, H10


[11244599] The device associated with this report was not returned. Review of the device history records and/or a complaint database search was not possible as the product and lot code required was not provided. Requests for additional investigational inputs were made in accordance with wi-7915 appendix a. No additional information was obtained. The investigation could not verify or identify any product contribution to the reported event with the information provided. Based on the inability to identify root cause, the need for corrective action was not indicated. Depuy considers the investigation closed at this time. Should the additional information be received, the investigation will be re-opened.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2013-30898
MDR Report Key3418432
Report Source05,08
Date Received2013-10-18
Date of Report2013-10-01
Date of Event2013-10-01
Date Mfgr Received2013-10-01
Date Added to Maude2013-10-18
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 ContactSTACEY TRICK
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46581
Manufacturer CountryUS
Manufacturer Postal46581
Manufacturer Phone5743714554
Manufacturer G1DEPUY ORTHOPAEDICS INC
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46581
Manufacturer CountryUS
Manufacturer Postal Code46581
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN DEPUY 41MM PATELLA
Generic NamePATELLA PROSTHESIS
Product CodeHTG
Date Received2013-10-18
Catalog NumberUNK-KNEE
Lot NumberUNKNOWN
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS INC
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 46581 US 46581


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2013-10-18

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