FDA Adverse Event
Injury
Summary report: N
UNKNOWN RIGHT REJUVENATE/ABGII HIP
MDR report key: 2821531
·
Received October 24, 2012
Report
- Report Number
- 2249697-2012-01981
- Event Type
- Injury
- Date Received
- October 24, 2012
- Date of Event
- April 1, 2012
- Report Date
- October 3, 2012
- Manufacturer
- STRYKER ORTHOPAEDICS MAHWAH
- Product Code
- MEH
- PMA / PMN Number
- UNK
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AR, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
AT THIS TIME, THE PT WAS UNABLE TO IDENTIFY THE DEVICES IMPLANTED, HOWEVER, BELIEVES THEM TO BE EITHER REJUVENATE OR ABG II. ADDITIONAL INFO HAS BEEN REQUESTED AND IF RECEIVED, WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE PT IS EXPERIENCING SOME PAIN IN RIGHT HIP. PT ALSO STATES THAT HE HAS TO LEAN SIDEWAYS WHEN DRIVING. PT HAS A PENDING APPOINTMENT TO HAVE BLOOD WORK AND X-RAYS DONE ON (B)(6) 2012 AT THE HOSPITAL WHERE HE HAD THE SURGERY. PT HAS ALSO HAD A LEFT HIP IMPLANTED AT THE SAME TIME AS THE RIGHT HIP, BUT LEFT HIP IS CURRENTLY ASYMPTOMATIC.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNKNOWN RIGHT REJUVENATE/ABGII HIP | IMPLANT | MEH | STRYKER ORTHOPAEDICS MAHWAH | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 77 YR | Other |