BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OFFSET ADAPTER

    MDR report key: 652271 · Received November 21, 2005

    Report

    Report Number
    9610726-2005-00063
    Event Type
    Injury
    Date Received
    November 21, 2005
    Date of Event
    October 31, 2005
    Report Date
    November 3, 2005
    Manufacturer
    STRYKER ORTHOPAEDICS LIMERICK
    Product Code
    FJP
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VT, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE OFFSET ADAPTER HAD FRACTURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OFFSET ADAPTER IMPLANT FJP STRYKER ORTHOPAEDICS LIMERICK NA 7912574

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Required Intervention