FDA Adverse Event
Injury
Summary report: N
TRI PRESS-FIT STEM 12X150MM
MDR report key: 2901372
·
Received December 14, 2012
Report
- Report Number
- 2249697-2012-02624
- Event Type
- Injury
- Date Received
- December 14, 2012
- Date of Event
- June 7, 2011
- Report Date
- November 27, 2012
- Manufacturer
- STRYKER ORTHOPAEDICS MAHWAH
- Product Code
- JWH
- PMA / PMN Number
- K070095
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
ADDITIONAL INFORMATION HAS BEEN REQUESTED FROM THE PATIENT AND IF RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.
Description of Event or Problem · 1
.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | TRI PRESS-FIT STEM 12X150MM | IMPLANT | JWH | STRYKER ORTHOPAEDICS MAHWAH | NA | M3T19K |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | Other |