BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN LEFT NECK

    MDR report key: 2885020 · Received December 12, 2012

    Report

    Report Number
    9616680-2012-01343
    Event Type
    Injury
    Date Received
    December 12, 2012
    Date of Event
    August 2, 2011
    Report Date
    November 28, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    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

    AT THIS TIME, THE PATIENT WAS UNABLE TO IDENTIFY THE DEVICES IMPLANTED, HOWEVER BELIEVES THEM TO BE EITHER REJUVENATE OR ABG II. 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 STARTED HAVING PAIN ON THE OUTSIDE MIDDLE PART OF HIS HIP IN MAY. PATIENT STATES THAT HE WAS LIMPING. PATIENT HAS HAD MRI AND BLOOD WORK PERFORMED.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Other