inforMED
InjuryLWJ

PROFEMUR® MODULAR FEMORAL NECK

Received Feb 13, 2023

Report 3010536692-2023-00019 · MDR key 16362089

Device

Generic name

Hip Component

Model number

PHA01204

Catalog number

PHA01204

Lot number

029820039

Product problems

  • Corroded
  • Corroded

Patient

Unknown

  • Metal Related Pathology
  • Metal Related Pathology

Narrative

Additional Manufacturer Narrative

THIS EVENT WILL BE UPDATED ONCE THE INVESTIGATION IS COMPLETE. TRENDS WILL BE EVALUATED.

Description of Event or Problem

ALLEGEDLY, PATIENT WAS REVISED DUE TO ADVERSE SOFT TISSUE REACTION TO PARTICULATE DEBRIS REVISION NJR NUMBER: (B)(6). SIDE:L. PRIMARY ASA: P1 - FIT AND HEALTHY. NON-MPO PRODUCTS: PRODUCT ID: 924760000 DURALOC SHELL 100 POLISHED HYDROXYAPATITE COATED 60MM/ LOT. NUMBER: 2732052/ QTY: 1. PRODUCT ID: 124260025 ENDURON PE LINER 10D 32/60 OR 72MM/ LOT. NUMBER: 1878654/ QTY: 1.