UNKNOWN_RECONSTRUCTIVE_PRODUCT UNK_REC

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,other report with the FDA on 2015-08-26 for UNKNOWN_RECONSTRUCTIVE_PRODUCT UNK_REC manufactured by Stryker Orthopaedics-mahwah.

Event Text Entries

[24086778] Catalogue number unknown at this time. Device description reported as an unknown duracon non beaded baseplate. An evaluation of the device cannot be performed as the device and medical records were not made available to the manufacturer due to hospital policy. Should additional information become available it will be reported in a supplemental report upon completion of the investigation. Not returned to the manufacturer.
Patient Sequence No: 1, Text Type: N, H10


[24086779] It was reported that the patient had an event getting into or out of the shower and presented with pain. Surgeon revised the patient's right duracon tibial baseplate and poly as the baseplate was found to be cracked.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0002249697-2015-02786
MDR Report Key5031364
Report SourceHEALTH PROFESSIONAL,OTHER
Date Received2015-08-26
Date of Report2015-07-29
Date of Event2015-07-29
Date Mfgr Received2015-07-29
Date Added to Maude2015-08-26
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 FDA3
Event Location3
Manufacturer ContactMR. JADWIGA DEGRADO
Manufacturer Street325 CORPORATE DRIVE
Manufacturer CityMAHWAH NJ 07430
Manufacturer CountryUS
Manufacturer Postal07430
Manufacturer Phone2018315000
Manufacturer G1STRYKER ORTHOPAEDICS-MAHWAH
Manufacturer Street325 CORPORATE DRIVE
Manufacturer CityMAHWAH NJ 07430
Manufacturer CountryUS
Manufacturer Postal Code07430
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN_RECONSTRUCTIVE_PRODUCT
Generic NameIMPLANT
Product CodeHSH
Date Received2015-08-26
Catalog NumberUNK_REC
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ORTHOPAEDICS-MAHWAH
Manufacturer Address325 CORPORATE DRIVE MAHWAH NJ 07430 US 07430


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2015-08-26

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