BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TRIDENT PSL HA CLUSTER 54MM

    MDR report key: 1110687 · Received August 4, 2008

    Report

    Report Number
    1110687
    Event Type
    Injury
    Date Received
    August 4, 2008
    Date of Event
    June 12, 2008
    Report Date
    July 9, 2008
    Manufacturer
    STRYKER ORTHOPAEDICS
    Product Code
    KWY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    OK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED VIA USER FACILITY THAT; "PT WAS ADMITTED FOR REVISION OF LEFT TOTAL HIP, SECONDARY TO PAIN & RECURRENT DISLOCATIONS."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRIDENT PSL HA CLUSTER 54MM IMPLANT KWY STRYKER ORTHOPAEDICS NA 29837902

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR Required Intervention