FDA Adverse Event Malfunction Summary report: N

JAPANESE OMNIFIT EON CS 132 NKSIZE 9 STEM 40 MM 13

MDR report key: 1082454 · Received July 22, 2008

Report

Report Number
9616680-2008-00216
Event Type
Malfunction
Date Received
July 22, 2008
Date of Event
April 23, 2008
Report Date
April 23, 2008
Manufacturer
STRYKER ORTHOPAEDICS CORK
Product Code
KWY
PMA / PMN Number
K020989
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

DURING THE SURGERY THE NURSE FOUND THE HOLE IN THE TYVEK SHEET WHEN SHE OPENED THE OUTER BOX OF THE STEM SIZE #9 (J6098-0940). THEN THE SURGEON USED SIZE #8 STEM (J6098-0835) INSTEAD OF #9.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 JAPANESE OMNIFIT EON CS 132 NKSIZE 9 STEM 40 MM 13 IMPLANT KWY STRYKER ORTHOPAEDICS CORK NA 12201202

Patients

Seq Age Sex Outcome Treatment
1 UNK Other