FDA Adverse Event Injury Summary report: N

PCA 7MM, LEFT, STEMMED TIBIAL COM

MDR report key: 625388 · Received July 12, 2005

Report

Report Number
2249697-2005-00086
Event Type
Injury
Date Received
July 12, 2005
Date of Event
June 8, 2005
Report Date
July 12, 2005
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
JWH
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

SINCE AROUND 2002 THE PATIENT COMPLAINED OF A PAIN AT THE KNEE, AND THE SURGEON FOUND OSTEOLYSIS BY X-RAYS. FROM 2003 TO 2004 OSTEOLYSIS BY X-RAYS. FROM 2003 TO 2004 OSTEOLYSIS WAS WORSE, AND THE SURGEON FOUND THAT THE TIBAL TRAY BROKE. THE SURGEON PERFORMED REVISION SURGERY IN 2005.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PCA 7MM, LEFT, STEMMED TIBIAL COM IMPLANT JWH STRYKER ORTHOPAEDICS MAHWAH NA OZFJO2

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention