BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRIATHLON P/A CR BEADED #4L

    MDR report key: 1629253 · Received February 5, 2010

    Report

    Report Number
    9610726-2009-00280
    Event Type
    Malfunction
    Date Received
    February 5, 2010
    Date of Event
    July 13, 2006
    Report Date
    February 5, 2010
    Manufacturer
    STRYKER ORTHOPAEDICS LIMERICK
    Product Code
    MBH
    PMA / PMN Number
    K051380
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    AS PART OF A QUALITY SYSTEM IMPROVEMENT PLAN STRYKER CORPORATION CONDUCTED A 2 YEAR RETROSPECTIVE MDR REVIEW TO ENSURE APPROPRIATE MDR REPORTING DECISIONS. EVENTS REPORTED TO STRYKER FROM (B) (6) 2006 TO (B) (6) 2008 WERE THE SCOPE OF THIS RETROSPECTIVE REVIEW. THESE EVENTS ARE PART OF A RETROSPECTIVE SUMMARY REPORT BEING SUBMITTED UNDER EXEMPTION # (B) (4). THERE IS 1 EVENT ASSOCIATED WITH THIS EVENT TYPE (DIMENSIONAL DISCREPANCY) AND PRODUCT CODE (MBH).

    Description of Event or Problem · 1

    DIMENSIONAL DISCREPANCY. PRESS FIT FEMORAL COMPONENT WAS VERY LOOSE, OVERSIZED BY APPROXIMATELY 4MM IN THE AP. PROSTHESIS HAD TO BE CEMENTED ON TO THE FEMUR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRIATHLON P/A CR BEADED #4L IMPLANT MBH STRYKER ORTHOPAEDICS LIMERICK NA SA33X

    Patients

    Seq Age Sex Outcome Treatment
    1 NA