BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SIMPLEX P - US FULL DOSE 10-PK

    MDR report key: 1830056 · Received September 7, 2010

    Report

    Report Number
    9610726-2010-00282
    Event Type
    Malfunction
    Date Received
    September 7, 2010
    Date of Event
    August 23, 2010
    Report Date
    August 24, 2010
    Manufacturer
    STRYKER ORTHOPAEDICS LIMERICK
    Product Code
    LOD
    PMA / PMN Number
    N17004
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, IT WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT, "RECEIVED A BOX OF BONE CEMENT THAT WAS DAMAGED. CRUSHED."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SIMPLEX P - US FULL DOSE 10-PK IMPLANT LOD STRYKER ORTHOPAEDICS LIMERICK NA RFR109

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Other