BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN LEFT ABGII HIP

    MDR report key: 2821418 · Received October 23, 2012

    Report

    Report Number
    9616680-2012-00917
    Event Type
    Injury
    Date Received
    October 23, 2012
    Date of Event
    February 22, 2011
    Report Date
    October 2, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    Product Code
    KWY
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    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 IS REPORTED THAT THE PATIENT IS EXPERIENCING DISCOMFORT WHILE EXERCISING. PATIENT IS ALSO EXPERIENCING PERIODIC DISCOMFORT AND SPORADIC ACHINESS ON THIGH AND HIP AREA. BLOOD TESTS AND BLOOD WORK PENDING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN LEFT ABGII HIP IMPLANT KWY STRYKER ORTHOPAEDICS CORK NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Other