STRYKER ACETABULAR DOME HOLE PLUG

Report

• Report Number: 2931792
• Date Received: December 27, 2012
• Date of Event: July 23, 2012
• Report Date: December 27, 2012
• Manufacturer: STRYKER
• Product Code: KWB
• Report Source: User Facility report
• Reporter Location: UT, US

Narratives

Description of Event or Problem · 1

PATIENT WAS ADMITTED WITH AN INFECTED RIGHT TOTAL HIP REPLACEMENT FROM 2010. THE PROSTHESIS WAS EXPLANTED. NOT A MALFUNCTION.

Devices

Seq	Brand	Generic	Product Code	Manufacturer	Model	Lot	UDI-DI
1	STRYKER ACETABULAR DOME HOLE PLUG	PROSTHESIS, HIP, ACETABULAR COMPONENT	KWB	STRYKER	*	1JK0D0
2	STRYKER TRITANIUM	PROSTHESIS, HIP, HEMISPHERICAL CLUSTER HOLE SHELL	LPH	STRYKER	*	502-03-56E
3	STRYKER TRIDENT	PROSTHESIS, HIP, POLYETHYLENE INSERT	LZO	STRYKER	C3 0* POLYETHYLENE INSERT	623-0040E
4	REJUVENATE	PROSTHESIS, HIP, MODULAR NECK	MEH	STRYKER	NLV-340880Y	*
5	STRYKER TORX	PROSTHESIS, HIP, CANCELLOUS BONE SCREW	HRS	STRYKER	*	MJMY05
6	STRYKER TORX	PROSTHESIS, HIP, CANCELLOUS BONE SCREW	HRS	STRYKER	*	MJLJDT
7	REJUVENATE SPT MODULAR STEM	PROSTHESIS, HIP, MODULAR STEM	MEH	STRYKER	*	MJD7K1
8	STRYKER LFIT ANATOMIC V40	PROSTHESIS, HIP, FEMORAL HEAD	LZO	STRYKER	*	MJL5H0

Patients

Seq	Age	Sex	Outcome	Treatment
1	72 YR

Terms

Patient problem · 1

• Unspecified Infection

Product problems · 1

• Adverse Event Without Identified Device or Use Problem

Type of report · 1

• Initial submission