FDA Adverse Event Injury Summary report: N

ALUMINA V40-FEMORAL HEAD 32MM, +0MM NK

MDR report key: 2232461 · Received August 25, 2011

Report

Report Number
9616680-2011-00555
Event Type
Injury
Date Received
August 25, 2011
Date of Event
April 11, 2007
Report Date
August 4, 2011
Manufacturer
STRYKER ORTHOPAEDICS CORK
Product Code
LZO
PMA / PMN Number
K023901
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION HAS BEEN REQUESTED AND IF RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT. CATALOG NUMBER AND LOT CODES OF OTHER DEVICES LISTED IN THIS REPORT: CAT# 625-0T-32F, LOT # 625-0T-32F, DESCRIPTION: TRIDENT ALUMINA INSERT.

Description of Event or Problem · 1

LETTER RECEIVED FROM A PATIENT REGARDING AN EVENT WHERE HE STATED THAT LEFT HIP REVISION SURGERY TO REPLACE ACETABULAR CERAMIC BEARING AS A RESULT OF 8 MONTHS OF HIP SQUEAKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALUMINA V40-FEMORAL HEAD 32MM, +0MM NK IMPLANT LZO STRYKER ORTHOPAEDICS CORK NA 9274002

Patients

Seq Age Sex Outcome Treatment
1 43 YR Required Intervention