BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EXETER V40 SHORT FEMORAL

    MDR report key: 2202396 · Received August 4, 2011

    Report

    Report Number
    9616680-2011-00517
    Event Type
    Injury
    Date Received
    August 4, 2011
    Date of Event
    July 15, 2011
    Report Date
    July 21, 2011
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    Product Code
    JDI
    PMA / PMN Number
    K011623
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    WHEN COMPLETED, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    THE SALES REP REPORTED A FRACTURED EXETER STEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EXETER V40 SHORT FEMORAL IMPLANT JDI STRYKER ORTHOPAEDICS CORK NA G1852750 44

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Required Intervention