FDA Adverse Event Injury Summary report: N

UNKNOWN_RECONSTRUCTIVE_PRODUCT

MDR report key: 2931773 · Received January 28, 2013

Report

Report Number
0002249697-2013-00384
Event Type
Injury
Date Received
January 28, 2013
Date of Event
January 9, 2013
Report Date
January 9, 2013
Manufacturer
STRYKER ORTHOPAEDICS-MAHWAH
Product Code
MEH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CATALOGUE NUMBER UNKNOWN AT THIS TIME. DEVICE DESCRIPTION REPORTED AS UNKNOWN REJUVENATE MODULAR NECK RIGHT HIP. ADDITIONAL INFORMATION HAS BEEN REQUESTED AND IF RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT. NOT RETURNED TO MANUFACTURER.

Additional Manufacturer Narrative · 1

AN EVENT REGARDING ALTR INVOLVING AN UNKNOWN REJUVENATE MODULAR DEVICE WAS REPORTED. THE EVENT WAS CONFIRMED. A SEARCH OF THE SUPER AND CHS COMPLAINT DATABASES COULD NOT BE PERFORMED AS THE REPORTED DEVICE WAS NOT PROPERLY IDENTIFIED. SIMILAR EVENTS HAVE OCCURRED FOR THE REJUVENATE MODULAR PRODUCT FAMILY. THESE EVENTS WERE DETERMINED TO BE ASSOCIATED WITH RA 2012-067. VOLUNTARY RECALL RA 2012-067 WAS INITIATED FOR ABGII AND REJUVENATE MODULAR STEMS AND NECKS DUE TO THE POTENTIAL RISKS ASSOCIATED WITH THESE DEVICES. THE REPORTED ALTR IS CONSIDERED TO BE UNDER THE SCOPE OF THIS RECALL.

Description of Event or Problem · 1

THE PATIENT IS SCHEDULED FOR REVISION SURGERY FOLLOWING A DIAGNOSIS OF ALTR. THE PATIENT IS NOTED TO BE ASYMPTOMATIC. THE FOLLOWING MEASUREMENTS WERE RECORDED AT 42 MONTHS SINCE INDEX SURGERY: COBALT - 8.8; CHROMIUM - 2.9. INFECTION WAS NOT DIAGNOSED.

Description of Event or Problem · 1

THE PATIENT IS SCHEDULED FOR REVISION SURGERY FOLLOWING A DIAGNOSIS OF ALTR. THE PATIENT IS NOTED TO BE ASYMPTOMATIC. THE FOLLOWING MEASUREMENTS WERE RECORDED AT 42 MONTHS SINCE INDEX SURGERY: COBALT - 8.8; CHROMIUM - 2.9. INFECTION WAS NOT DIAGNOSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
36910 UNKNOWN_RECONSTRUCTIVE_PRODUCT IMPLANT MEH STRYKER ORTHOPAEDICS-MAHWAH

Patients

Seq Age Sex Outcome Treatment
1 Other