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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS CORK UNKNOWN REJUVENATE MODULAR NECK IMPLANT

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STRYKER ORTHOPAEDICS CORK UNKNOWN REJUVENATE MODULAR NECK IMPLANT Back to Search Results
Device Problem Device Operates Differently Than Expected (2913)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 03/26/2012
Event Type  Injury  
Event Description

It was reported that, "dr. (b)(6) has sent a communication to the team that he has four potentials cases of rejuvenate that have metal sensitivity from the modular neck and stem. ".

 
Manufacturer Narrative

An evaluation of the device cannot be performed as the device remained implanted in the patient and was not returned to the manufacturer. Additional information pertaining to the device referenced in this report (including x-rays and medical records) was requested. Should additional information become available, the evaluation summary will be submitted in a supplemental report. This is the same patient/event as mfr # 2249697-2012-00466.

 
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Brand NameUNKNOWN REJUVENATE MODULAR NECK
Type of DeviceIMPLANT
Manufacturer (Section D)
STRYKER ORTHOPAEDICS CORK
carrigtwohill, cork
EI
Manufacturer (Section G)
STRYKER ORTHOPAEDICS CORK
ida industrial estate
carrigtwohill, cork
EI
Manufacturer Contact
jadwiga degrado
325 corporate dr.
mahwah, NJ 07430
2018315000
MDR Report Key2544460
MDR Text Key19222450
Report Number9616680-2012-00270
Device Sequence Number1
Product Code MRA
Combination Product (Y/N)N
Reporter Country CodeUS
PMA/PMN NumberUNK
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation
Remedial Action Other
Type of Report Initial
Report Date 03/26/2012
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received04/17/2012
Is This An Adverse Event Report? Yes
Is This A Product Problem Report? No
Device Operator HEALTH PROFESSIONAL
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? Yes
Date Manufacturer Received03/26/2012
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 TREATMENT DATA
Date Received: 04/17/2012 Patient Sequence Number: 1
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