BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK LEFT HIP ABGII STEM

    MDR report key: 2912779 · Received January 7, 2013

    Report

    Report Number
    9616680-2013-90016
    Event Type
    Injury
    Date Received
    January 7, 2013
    Date of Event
    September 1, 2010
    Report Date
    December 10, 2012
    Manufacturer
    STRYKER ORTHOPAEDICS CORK
    Product Code
    MEH
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    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 THE HIP JOINT AND IS HAVING DIFFICULTY WALKING AND GOING UP STAIRS. PT STATES THAT HE WILL NEED REVISION SURGERY AND IT IS SCHEDULED FOR (B)(6) 2013.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    7980 UNK LEFT HIP ABGII STEM IMPLANT MEH STRYKER ORTHOPAEDICS CORK NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Other| R