BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN 28MM CERAMIC LINER SIZE D

    MDR report key: 2232470 · Received August 25, 2011

    Report

    Report Number
    9616680-2011-00554
    Event Type
    Injury
    Date Received
    August 25, 2011
    Date of Event
    August 3, 2011
    Report Date
    August 3, 2011
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    Product Code
    JDI
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    ADDITIONAL INFORMATION HAS BEEN REQUESTED AND IF RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT, "THERE WAS CLICKING SOUND IN THE HIP AND DOCTOR EXAMINED IN THE OFFICE, TOOK X-RAYS AND DECIDED TO REVISE THE PATIENT."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN 28MM CERAMIC LINER SIZE D IMPLANT JDI STRYKER ORTHOPAEDICS CORK NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other