FDA Adverse Event Injury Summary report: N

UNKNOWN STRYKER LEFT KNEE

MDR report key: 2860096 · Received December 4, 2012

Report

Report Number
2249697-2012-02517
Event Type
Injury
Date Received
December 4, 2012
Date of Event
October 19, 2001
Report Date
November 13, 2012
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
JWH
PMA / PMN Number
UNK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, 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 WAS REPORTED THAT THE PATIENT HAS BILATERAL KNEE IMPLANTS. THE PATIENT COMPLAINS OF PAIN, SWELLING, WEAKNESS AND INSTABILITY IN THE LEFT KNEE. THE PATIENT CANNOT STAND EVEN WITH ASSISTANCE AND MUST USE A WHEELCHAIR. THE PATIENT REPORTS THAT YOU CAN HEAR THE IMPLANTED PARTS MOVING IN THE KNEE. THE PATIENT WAS HOSPITALIZED ON (B)(6) 2012 FOR FIVE DAYS DUE TO INTENSE PAIN AND EXTREME SWELLING IN THE KNEE. SCANS REVEALED THAT THE LEFT IMPLANT IS UNSTABLE AND A REVISION SURGERY IS NEEDED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 84 YR Hospitalization| R