FDA Adverse Event Injury Summary report: N

AVON

MDR report key: 1678163 · Received May 6, 2010

Report

Report Number
9610726-2010-00144
Event Type
Injury
Date Received
May 6, 2010
Date of Event
March 18, 2010
Report Date
April 23, 2010
Manufacturer
STRYKER ORTHOPAEDICS LIMERICK
Product Code
KRR
PMA / PMN Number
UNK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVAL OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MFR. ADD'L INFO PERTAINING TO THE DEVICE(S) REFERENCED IN THIS REPORT WAS REQUESTED. IF IT BECOMES AVAILABLE, THE EVAL SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

IT WAS REPORTED THAT, "SURGEON REMOVED AVON FEMORAL COMPONENT AND CONVERTED TO A TRIATHLON TOTAL KNEE. SURGEON COMMENTED THAT PT WAS EXPERIENCING KNEE PAIN WITH THE AVON."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AVON IMPLANT KRR STRYKER ORTHOPAEDICS LIMERICK NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention