FDA Adverse Event Injury Summary report: N

ACCOLADE PLUS TMZF HIP STEM #3

MDR report key: 1881109 · Received October 20, 2010

Report

Report Number
9616680-2010-00652
Event Type
Injury
Date Received
October 20, 2010
Date of Event
September 29, 2010
Report Date
September 29, 2010
Manufacturer
STRYKER ORTHOPAEDICS CORK
Product Code
MEH
PMA / PMN Number
K023102
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, 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. ADDITIONAL INFO 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 BY THE PT, "PT IS HAVING PAIN IN HER HIP ALL THE TIME. EVERY TIME SHE GOES TO DO SOMETHING OR TWIST THE WRONG WAY, SHE FEELS A LOT OF PAIN AND IS ON BED REST FOR A FEW DAYS. PT BELIEVES HER HIP WAS PART OF THE RECALL. DOCTORS HAVE HER ON VICODIN 4 TIMES A DAY FOR PAIN. HER HIP REPLACEMENT WAS ON HER LEFT SIDE BUT THE PAIN IS SO SEVERE SHE ALSO FEELS THE PAIN ON HER RIGHT SIDE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCOLADE PLUS TMZF HIP STEM #3 IMPLANT MEH STRYKER ORTHOPAEDICS CORK NA 13383302

Patients

Seq Age Sex Outcome Treatment
1 42 YR