FDA Adverse Event Injury Summary report: N

ACCOLADE PLUS TMZF HIP STEM #3

MDR report key: 3070780 · Received April 22, 2013

Report

Report Number
0002249697-2013-01349
Event Type
Injury
Date Received
April 22, 2013
Date of Event
March 25, 2013
Report Date
March 25, 2013
Manufacturer
STRYKER ORTHOPAEDICS-MAHWAH
Product Code
MEH
PMA / PMN Number
K994366
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

IT WAS NOTED THAT THE DEVICE IS NOT AVAILABLE FOR EVALUATION AS IT REMAINS IMPLANTED. ADDITIONAL INFORMATION HAS BEEN REQUESTED AND IF RECEIVED, WILL BE PROVIDED IN THE SUPPLEMENTAL REPORT.

Additional Manufacturer Narrative · 1

THIS EVENT IS A DUPLICATE OF PI ((B)(4)).THIS EVENT HAS BEEN REPORTED UNDER MFR REPORT FOR REPORT #(0002249697-2013-02078).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DOCTOR REPORTED THE PATIENT'S METAL IONS WERE ELEVATED. CONCERN THAT IT IS FROM IMPLANTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DOCTOR REPORTED THE PATIENT'S METAL IONS WERE ELEVATED. CONCERN THAT IT IS FROM IMPLANTS. THIS EVENT IS A DUPLICATE OF PI ((B)(4)).THIS EVENT HAS BEEN REPORTED UNDER MFR REPORT FOR REPORT #(0002249697-2013-02078).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
172262 ACCOLADE PLUS TMZF HIP STEM #3 IMPLANT MEH STRYKER ORTHOPAEDICS-MAHWAH 33961101

Patients

Seq Age Sex Outcome Treatment
1 76 YR Other