FDA Adverse Event Injury Summary report: N

UNKNOWN RIGHT HIP STEM

MDR report key: 2910438 · Received January 4, 2013

Report

Report Number
2249697-2013-90027
Event Type
Injury
Date Received
January 4, 2013
Date of Event
July 7, 2010
Report Date
December 13, 2012
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
MEH
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AT THIS TIME, THE PATIENT 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 PATIENT IS EXPERIENCING PAIN IN HER HIP. THE PATIENT ALSO STATES THAT IT IS PAINFUL TO WALK AND THAT SHE HAD FLUID IN HER HIP. THE PATIENT STATES THAT HER COBALT LEVEL IS ELEVATED AND HER CHROMIUM IS NORMAL. THE PATIENT HAD AN MRI DONE. SHE IS SCHEDULED FOR REVISION SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
5327 UNKNOWN RIGHT HIP STEM IMPLANT MEH STRYKER ORTHOPAEDICS MAHWAH NA UNK

Patients

Seq Age Sex Outcome Treatment
1 65 YR Other