FDA Adverse Event Injury Summary report: N

UNKNOWN PRODUCT

MDR report key: 1060382 · Received June 12, 2008

Report

Report Number
2249697-2008-00168
Event Type
Injury
Date Received
June 12, 2008
Date of Event
June 20, 2007
Report Date
May 6, 2008
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
JDI
PMA / PMN Number
UNK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED. NO EVAL WILL BE PERFORMED. IF DEVICE BECOMES AVAILABLE A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED BY THE DR THAT, "PT HAD A FRACTURE DISLOCATION OF HIS HIP WITH PINNING, AND IN 2007 HE STARTED HAVING LEFT HIP PAIN AND OF ASEPTIC LOOSENING WAS MADE BASED ON THE X-RAY"

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN PRODUCT IMPLANT JDI STRYKER ORTHOPAEDICS MAHWAH NA UNK

Patients

Seq Age Sex Outcome Treatment
1 73 YR Required Intervention