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