BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN PRODUCT - HIP IMPLANT

    MDR report key: 1113181 · Received August 12, 2008

    Report

    Report Number
    9616680-2008-00238
    Event Type
    Injury
    Date Received
    August 12, 2008
    Date of Event
    July 24, 2008
    Report Date
    July 24, 2008
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    Product Code
    JDI
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    HI, US
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION PERTAINING TO THE DEVICE(S) REFERENCED IN THIS REPORT WAS REQUESTED. IF IT BECOMES AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATIENT STATED THAT FOR THE PAST THREE MONTHS, HE HAS BEEN EXPERIENCED SQUEAKING AND ALSO PAIN ON HIS LEFT HIP. HE STATED THAT THE SQUEAKING IS MORE PROMINENT WHEN HE GOES UP THE STAIRS OR LIFTS SOMETHING.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR