FDA Adverse Event Injury Summary report: N

UNKNOWN RIGHT HIP NECK

MDR report key: 2910437 · Received January 4, 2013

Report

Report Number
9616680-2013-90024
Event Type
Injury
Date Received
January 4, 2013
Date of Event
October 27, 2011
Report Date
December 14, 2012
Manufacturer
STRYKER ORTHOPAEDICS CORK
Product Code
MEH
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AT THIS TIME, THE PT WAS UNABLE TO IDENTIFY THE DEVICES IMPLANTED BUT BELIEVES THEM TO BE EITHER REJUVENATE OR ABG II. ADD'L 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 IS EXPERIENCING PAIN IN HER RIGHT LEG. THE PT STATES THAT SHE HAD X-RAYS AND BLOOD WORK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
5522 UNKNOWN RIGHT HIP NECK IMPLANT MEH STRYKER ORTHOPAEDICS CORK NA UNK

Patients

Seq Age Sex Outcome Treatment
1 87 YR Other