BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSTRAINED ACETABULAR INSERTS

    MDR report key: 1911261 · Received November 23, 2010

    Report

    Report Number
    2249697-2010-01599
    Event Type
    Injury
    Date Received
    November 23, 2010
    Date of Event
    November 1, 2010
    Report Date
    November 1, 2010
    Manufacturer
    STRYKER ORTHOPAEDICS MAHWAH
    Product Code
    KWZ
    PMA / PMN Number
    K061654
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, 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 (INCLUDING X-RAYS AND MEDICAL RECORDS) WAS REQUESTED. IF ADDITIONAL INFO BECOMES AVAILABLE, THE EVAL SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT, "CONSTRAINED LINER DISLOCATED."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CONSTRAINED ACETABULAR INSERTS IMPLANT KWZ STRYKER ORTHOPAEDICS MAHWAH NA 1030448E

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Other| R