FDA Adverse Event Injury Summary report: N

UNKNOWN_RECONSTRUCTIVE_PRODUCT

MDR report key: 2933295 · Received January 29, 2013

Report

Report Number
0002249697-2013-00399
Event Type
Injury
Date Received
January 29, 2013
Date of Event
January 1, 2012
Report Date
January 15, 2013
Manufacturer
STRYKER ORTHOPAEDICS-MAHWAH
Product Code
MEH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CATALOG NUMBER IS UNKNOWN AT THIS TIME. THE DEVICE WAS REPORTED AS UNKNOWN REJUVENATE/ABG II STEM. 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) HAS BEEN REQUESTED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT. REMAINS IMPLANTED.

Additional Manufacturer Narrative · 1

AN EVENT REGARDING REVISION SURGERY INVOLVING AN UNKNOWN REJUVENATE/ABGII MODULAR DEVICE WAS REPORTED. THE EVENT WAS CONFIRMED. DEVICE EVALUATION WAS NOT PERFORMED AS NO DEVICES WERE RECEIVED. SIMILAR EVENTS HAVE OCCURRED FOR THE REJUVENATE AND ABGII MODULAR PRODUCT FAMILIES. 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 REVISION SURGERY IS CONSIDERED TO BE UNDER THE SCOPE OF THIS RECALL. NO FURTHER INVESTIGATION IS REQUIRED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT IS EXPERIENCING PAIN.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING PAIN AND UDNERWENT REVISION SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
38487 UNKNOWN_RECONSTRUCTIVE_PRODUCT IMPLANT MEH STRYKER ORTHOPAEDICS-MAHWAH

Patients

Seq Age Sex Outcome Treatment
1 Other| R