FDA Adverse Event Injury Summary report: N

UNKNOWN LEFT STRYKER HIP

MDR report key: 2850806 · Received November 21, 2012

Report

Report Number
2249697-2012-02443
Event Type
Injury
Date Received
November 21, 2012
Date of Event
July 1, 2008
Report Date
November 2, 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
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE REMAINED IMPLANTED IN THE PATIENT AND WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION PERTAINING TO THE DEVICE REFERENCED IN THIS REPORT (INCLUDING X-RAYS AND MEDICAL RECORDS) HAS BEEN REQUESTED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

IT IS REPORTED THAT: PATIENT STATED THAT SHE HAS A LEFT STRYKER HIP AS WELL THAT IS GIVING HER PROBLEMS WITH HIP AND BACK PAIN. LEFT SURGERY TOOK PLACE IN (B)(6) 2008 AT (B)(6) HOSPITAL WITH DR (B)(6).

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 50 YR Other