FDA Adverse Event Injury Summary report: N

UNKNOWN LEFT HIP REJUVENATE/ ABGII NECK

MDR report key: 2871921 · Received December 6, 2012

Report

Report Number
9616680-2012-01309
Event Type
Injury
Date Received
December 6, 2012
Date of Event
May 12, 2020
Report Date
February 21, 2023
Manufacturer
STRYKER ORTHOPAEDICS CORK
Product Code
MEH
PMA / PMN Number
K092561
Removal / Correction Number
Z-2089-2012
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, 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 HAS PAIN AT THE HIP JOINT. ANYTIME THE PT MOVES IT HURTS. PT HAD CHECK-UP VISIT (B)(6) 2012. PT IS GOING TO HAVE AN ULTRA SOUND DONE, BECAUSE, PT HAS A PACE MAKER AND CAN NOT HAVE A MRI.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN LEFT HIP REJUVENATE/ ABGII NECK IMPLANT MEH STRYKER ORTHOPAEDICS CORK NA UNK

Patients

Seq Age Sex Outcome Treatment
1 83 YR Female Hospitalization| O| R