MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,08 report with the FDA on 2015-03-11 for PINN CAN BONE SCREW 6.5MMX20MM 121720500 manufactured by Johnson & Johnson Medical (suzhou) Ltd. 3006356043.
[5632688]
Patient was revised to address acetabular cup loosening. It was noted that the cup had become loose due to a hole on the anterior medial side of the cup.
Patient Sequence No: 1, Text Type: D, B5
[13011163]
This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. (b)(4).
Patient Sequence No: 1, Text Type: N, H10
[13420375]
The complaint states patient was revised to address acetabular cup loosening. It was noted that the cup had become loose due to a hole on the anterior medial side of the cup. A complaints database search and review of manufacturing records did not identify any anomalies. Without further information or return of products the root cause of the complaint cannot be confirmed. The complaint shall be closed with an undetermined conclusion and entered into the complaint database and monitored through trend analysis. If further information is received the complaint shall be reopened and investigated further. No further actions are identified. Post market surveillance is per sep (b)(4).
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1818910-2015-15915 |
| MDR Report Key | 4592292 |
| Report Source | 05,08 |
| Date Received | 2015-03-11 |
| Date of Report | 2015-02-23 |
| Date of Event | 2015-02-23 |
| Date Mfgr Received | 2015-05-28 |
| Device Manufacturer Date | 2014-06-06 |
| Date Added to Maude | 2015-03-11 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | STEVE DOWELL |
| Manufacturer Street | 700 ORTHOPAEDIC DRIVE |
| Manufacturer City | WARSAW IN 46581 |
| Manufacturer Country | US |
| Manufacturer Postal | 46581 |
| Manufacturer Phone | 5743714918 |
| Manufacturer G1 | JOHNSON & JOHNSON MEDICAL (SUZHOU) LTD. 3006356043 |
| Manufacturer Street | NO.299 CHANGYANG ST SUZHOU INDUSTRIAL PARK |
| Manufacturer City | SUZHOU, JIANGSU 21512-6 |
| Manufacturer Country | CH |
| Manufacturer Postal Code | 21512-6 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PINN CAN BONE SCREW 6.5MMX20MM |
| Generic Name | HIP OTHER IMPLANT |
| Product Code | NDJ |
| Date Received | 2015-03-11 |
| Catalog Number | 121720500 |
| Lot Number | D14022713 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | JOHNSON & JOHNSON MEDICAL (SUZHOU) LTD. 3006356043 |
| Manufacturer Address | NO.299 CHANGYANG ST SUZHOU INDUSTRIAL PARK SUZHOU, JIANGSU 21512-6 CH 21512-6 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2015-03-11 |