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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US PRODIGY SM STAT LNG LT 15.0MM PRODIGY HIP STEM : HIP FEMORAL STEM

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DEPUY ORTHOPAEDICS INC US PRODIGY SM STAT LNG LT 15.0MM PRODIGY HIP STEM : HIP FEMORAL STEM Back to Search Results
Catalog Number 152024050
Device Problems Biocompatibility; Adverse Event Without Identified Device or Use Problem
Event Date 10/19/2012
Event Type  Injury  
Manufacturer Narrative

Product complaint # (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. Occupation: lawyer.

 
Event Description

Ppf alleges elevated metal ions.

 
Search Alerts/Recalls

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Brand NamePRODIGY SM STAT LNG LT 15.0MM
Type of DevicePRODIGY HIP STEM : HIP FEMORAL STEM
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
JTE WARSAW MFG SITE
700 orthopaedic drive
warsaw IN 46582
Manufacturer Contact
kara ditty-bovard
700 orthopaedic drive
warsaw , IN 46581-0988
6107428552
MDR Report Key8627212
Report Number1818910-2019-94100
Device Sequence Number1
Product CodeLPH
Report Source Manufacturer
Source Type CONSUMER,OTHER
Reporter Occupation
Type of Report Initial,Followup
Report Date 09/16/2015
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received05/21/2019
Is This An Adverse Event Report? Yes
Is This A Product Problem Report? No
Device Operator HEALTH PROFESSIONAL
Device Catalogue Number152024050
Device LOT NumberA4XEH1000
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? No
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received10/30/2019
Was Device Evaluated By Manufacturer? Device Not Returned To Manufacturer
Date Device Manufactured10/12/2006
Is The Device Single Use? Yes
Is this a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient TREATMENT DATA
Date Received: 05/21/2019 Patient Sequence Number: 1
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