MAUDE Adverse Event Report: HIP REPLACEMENT; PROSTHESIS HIP

Device Problem Device Slipped (1584)

Patient Problem Insufficient Information (4580)

Event Date 10/01/2012

Event Type  Injury  

Event Description

Hip replacement metal is coming out of my body.Fda safety report id# (b)(4).

• Brand Name: HIP REPLACEMENT
• Type of Device: PROSTHESIS HIP
• MDR Report Key: 15597629
• MDR Text Key: 301862566
• Report Number: MW5112616
• Device Sequence Number: 1
• Product Code: LPH
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 10/10/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 10/12/2022
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Was Device Available for Evaluation?: Yes
• Patient Sequence Number: 1
• Treatment: CANNABIS
• Patient Outcome(s): Required Intervention; Life Threatening; Disability; Other; Hospitalization
• Patient Age: 45 YR
• Patient Sex: Male
• Patient Weight: 66 KG
• Patient Ethnicity: Non Hispanic
• Patient Race: White