FDA Adverse Event Injury Summary report: N

SCORPIOFLEX TOTAL KNEE PS

MDR report key: 2182477 · Received July 19, 2011

Report

Report Number
2249697-2011-01085
Event Type
Injury
Date Received
July 19, 2011
Date of Event
June 20, 2011
Report Date
June 29, 2011
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
JWH
PMA / PMN Number
K041591
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE FOLLOWING OTHER KNEE DEVICES WERE ALSO LISTED IN THIS REPORT: SERIES 7000 STANDARD TIBIA CAT# 7115-0009, LOT# M34MDA. UNKNOWN FEMUR; CAT# UNK, LOT# UNK, UNKNOWN PATELLA; CAT# UNK, LOT# UNK. IT CANNOT BE DETERMINED WHICH, IF ANY OF THESE DEVICES MAY HAVE CAUSED OR CONTRIBUTED TO THE PATIENT'S STIFFNESS. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT, "DEVICES REMOVED FOR STIFFNESS."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SCORPIOFLEX TOTAL KNEE PS IMPLANT JWH STRYKER ORTHOPAEDICS MAHWAH NA 1ZLEW

Patients

Seq Age Sex Outcome Treatment
1 59 YR Required Intervention