FDA Adverse Event Injury Summary report: N

UNKNOWN STRYKER KNEE - LEFT

MDR report key: 2070922 · Received April 19, 2011

Report

Report Number
2249697-2011-00519
Event Type
Injury
Date Received
April 19, 2011
Date of Event
May 19, 2009
Report Date
March 28, 2011
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
JWH
PMA / PMN Number
UNK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE(S) WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION PERTAINING TO THE DEVICE(S) REFERENCED IN THIS REPORT (INCLUDING X-RAYS AND MEDICAL RECORDS) WAS REQUESTED. IF DEVICE OR ADDITIONAL INFORMATION BECOMES AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

IT WAS REPORTED THAT "PATIENT'S HUSBAND E-MAILED STRYKER AND STATED: "(B)(6) HAD A KNEE REVISION (B)(6) 2009 AT (B)(6) HOSPITAL."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN STRYKER KNEE - LEFT IMPLANT JWH STRYKER ORTHOPAEDICS MAHWAH NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention