HYDROSET INJECTABLE CEMENT KIT 15CC 397015

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-06-25 for HYDROSET INJECTABLE CEMENT KIT 15CC 397015 manufactured by Stryker Orthopaedics-limerick.

Event Text Entries

[112165186] Device is not available for evaluation. If additional information is received it will be reported on a supplemental report. Device cannot be sterilized so returning is not an option.
Patient Sequence No: 1, Text Type: N, H10


[112165187] It was reported that patient's right hip was revised. As reported by rep: "patient had an infection and had some components exchanged during the i and d".
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0008010177-2018-00055
MDR Report Key7633657
Report SourceHEALTH PROFESSIONAL
Date Received2018-06-25
Date of Report2018-10-12
Date of Event2018-05-30
Date Mfgr Received2018-05-30
Device Manufacturer Date2017-11-23
Date Added to Maude2018-06-25
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. KELLI DYKSTRA
Manufacturer StreetBOETZINGERSTR. 41
Manufacturer CityFREIBURG D-79111
Manufacturer PostalD-79111
Manufacturer Phone76145120
Manufacturer G1STRYKER ORTHOPAEDICS-LIMERICK
Manufacturer StreetRAHEEN BUSINESS PARK
Manufacturer CityLIMERICK NA
Manufacturer Postal CodeNA
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHYDROSET INJECTABLE CEMENT KIT 15CC
Generic NameIMPLANT
Product CodeGXP
Date Received2018-06-25
Catalog Number397015
Lot NumberVB5S7
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ORTHOPAEDICS-LIMERICK
Manufacturer AddressRAHEEN BUSINESS PARK LIMERICK NA NA


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-06-25

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