FDA Adverse Event Injury Summary report: N

UNKNOWN_RECONSTRUCTIVE_PRODUCT

MDR report key: 2930038 · Received January 25, 2013

Report

Report Number
0002249697-2013-00292
Event Type
Injury
Date Received
January 25, 2013
Date of Event
October 9, 2012
Report Date
January 10, 2013
Manufacturer
STRYKER ORTHOPAEDICS-MAHWAH
Product Code
JWH
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CATALOGUE NUMBER UNKNOWN AT THIS TIME. DEVICE DESCRIPTION REPORTED AS UNKNOWN STRYKER RIGHT KNEE. ADDITIONAL INFORMATION HAS BEEN REQUESTED AND IF RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT. DEVICE EVALUATED BY MFR: NOT RETURNED TO MANUFACTURER.

Additional Manufacturer Narrative · 1

THE PATIENT IS (B)(6) IN HEIGHT. AN EVENT REGARDING PAIN INVOLVING A UNKNOWN STRYKER KNEE WAS REPORTED. THE EVENT WAS NOT CONFIRMED. CONCLUSIONS: THE EXACT CAUSE OF THE EVENT COULD NOT BE DETERMINED DUE TO INSUFFICIENT INFORMATION PROVIDED. PATIENT MEDICAL RECORDS WOULD BE NEEDED TO FURTHER EVALUATE THE REPORTED PAIN.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT EXPERIENCES PAIN WHEN WALKING AND LYING DOWN.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT EXPERIENCES PAIN WHEN WALKING AND LYING DOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
35249 UNKNOWN_RECONSTRUCTIVE_PRODUCT IMLANT JWH STRYKER ORTHOPAEDICS-MAHWAH UNK

Patients

Seq Age Sex Outcome Treatment
1 71 YR Other