BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN LEFT STRYKER HIP SYSTEM

    MDR report key: 2831117 · Received November 2, 2012

    Report

    Report Number
    2249697-2012-02146
    Event Type
    Injury
    Date Received
    November 2, 2012
    Date of Event
    December 1, 2011
    Report Date
    October 12, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS MAHWAH
    Product Code
    JDI
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    ADD'L 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 PAIN IN LEFT LEG. PT IS HAVING TROUBLE LYING IN BED. PT IS ALSO EXPERIENCING THROBBING IN TAILBONE. PT STATES THAT THE PAIN IS MORE AGGRESSIVE IN THE RIGHT HIP BUT IS STILL EXPERIENCING PAIN IN THE LEFT HIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN LEFT STRYKER HIP SYSTEM IMPLANT JDI STRYKER ORTHOPAEDICS MAHWAH NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other