BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK LEFT HIP STEM

    MDR report key: 2872094 · Received December 6, 2012

    Report

    Report Number
    2249697-2012-02599
    Event Type
    Injury
    Date Received
    December 6, 2012
    Date of Event
    August 3, 2012
    Report Date
    November 15, 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

    ADD'L INFO HAS BEEN REQUESTED AND IF RECEIVED, WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    THE PT REPORTED THAT BECAUSE OF A REVISION SURGERY ON 08/03/2012, HE HAD A FRACTURE ON HIS FEMUR. PT HAD A FRACTURE REDUCTION ON (B)(6) 2012. PT IS REPORTING THAT HE HAD THREE CABLES PLACED AROUND HIS FEMUR.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Other| R