BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REJUVENATE STRGHT PRFIT TMZF MOD STEM SIZE 7

    MDR report key: 2901626 · Received January 3, 2013

    Report

    Report Number
    2249697-2013-90002
    Event Type
    Injury
    Date Received
    January 3, 2013
    Date of Event
    December 12, 2012
    Report Date
    December 12, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS MAHWAH
    Product Code
    JDI
    PMA / PMN Number
    K071082
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AK, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT PT COMPLAINED OF HIP PAIN. DR REVISED TO BIOMET CUP AND STEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2600 REJUVENATE STRGHT PRFIT TMZF MOD STEM SIZE 7 IMPLANT JDI STRYKER ORTHOPAEDICS MAHWAH NA MKAKN7

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Other| R