BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN STRYKER RIGHT HIP

    MDR report key: 2910686 · Received January 8, 2013

    Report

    Report Number
    2249697-2013-90055
    Event Type
    Injury
    Date Received
    January 8, 2013
    Date of Event
    November 10, 2004
    Report Date
    December 14, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS MAHWAH
    Product Code
    JDI
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE REMAINED IMPLANTED IN THE PATIENT AND WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION PERTAINING TO THE DEVICE REFERENCED IN THIS REPORT (INCLUDING X-RAYS AND MEDICAL RECORDS) WAS REQUESTED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

    Description of Event or Problem · 1

    IT IS REPORTED THAT: PATIENT HAS HAD A DULL ACHE IN HIS HIP FOR THE PAST FEW MONTHS. PATIENT'S HIP BEGAN POPPING WITH EACH STEP A FEW WEEKS AGO. PATIENT HAS PAIN DAILY AND THE INTENSITY IS INCREASING. PATIENT IS SCHEDULING AN APPOINTMENT WITH A NEW ORTHOPAEDIST SOON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    9934 UNKNOWN STRYKER RIGHT HIP IMPLANT JDI STRYKER ORTHOPAEDICS MAHWAH NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Other