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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH UNITRAX MODULAR ENDO HEAD 53MM; PROSTHESIS, HIP, HEMI-, FEMORAL, METAL

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STRYKER ORTHOPAEDICS-MAHWAH UNITRAX MODULAR ENDO HEAD 53MM; PROSTHESIS, HIP, HEMI-, FEMORAL, METAL Back to Search Results
Catalog Number 6942-5-053
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Unspecified Infection (1930)
Event Date 11/26/2023
Event Type  Injury  
Manufacturer Narrative
It was noted that the device is not available for evaluation.Should additional information become available, it will be provided in a supplemental report upon completion of the investigation.The following devices were also listed in this report: device name#unitrax v40 sleeve +0mm (std) ; cat# 6942-6-065; lot#unknown.Device name#accolade distal spacer ; cat#6058-0537d; lot#unknown.Device name#accolade distal spacer ; cat#1059-4514 ; lot#unknown.It cannot be determined which, if any of these devices may have caused or contributed to the patient's experience.
 
Event Description
It was reported that the patient's left hip was revised due to infection.A unipolar head and sleeve were revised to a bipolar component and femoral head.
 
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Brand Name
UNITRAX MODULAR ENDO HEAD 53MM
Type of Device
PROSTHESIS, HIP, HEMI-, FEMORAL, METAL
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer (Section G)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer Contact
arokiya raj
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key18312834
MDR Text Key330300100
Report Number0002249697-2023-01550
Device Sequence Number1
Product Code KWL
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K014226
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Type of Report Initial
Report Date 12/12/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/12/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue Number6942-5-053
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received11/26/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Hospitalization; Required Intervention;
Patient Age58 YR
Patient SexMale
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