TRIATHLON P/A PS BEADED #3L 5516-F-301

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2011-11-16 for TRIATHLON P/A PS BEADED #3L 5516-F-301 manufactured by Stryker Orthopaedics Limerick.

Event Text Entries

[19870767] It was reported that, "the patient's lateral condyle compressed due to soft bone. The knee went into severe valgus. Surgeon revised with ts femur and stem. The doctor stated that the revision was not related to the components. "
Patient Sequence No: 1, Text Type: D, B5


[20279619] Additional information has been requested and if received will be provided in a supplemental report.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9610726-2011-00386
MDR Report Key2350513
Report Source07
Date Received2011-11-16
Date of Report2011-11-03
Date of Event2011-11-03
Date Mfgr Received2011-11-03
Device Manufacturer Date2010-09-21
Date Added to Maude2011-11-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactRITA INTORRELLA
Manufacturer Street325 CORPORATE DRIVE
Manufacturer CityMAHWAH NJ 07430
Manufacturer CountryUS
Manufacturer Postal07430
Manufacturer Phone2018315000
Manufacturer G1STRYKER ORTHOPAEDICS LIMERICK
Manufacturer StreetRAHEEN BUSINESS PARK
Manufacturer CityLIMERICK
Manufacturer CountryEI
Single Use3
Remedial ActionOT
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameTRIATHLON P/A PS BEADED #3L
Generic NameIMPLANT
Product CodeMAC
Date Received2011-11-16
Model NumberNA
Catalog Number5516-F-301
Lot NumberST4MC
ID NumberL9121
Device Expiration Date2015-09-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ORTHOPAEDICS LIMERICK
Manufacturer AddressLIMERICK EI


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2011-11-16

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