Brand Name | PROSTHESIS, HIP, HEMI-, FEMORAL, METAL/POLYMER, CEMENTED OR UNCEMENTED |
Type of Device | PROSTHESIS, HIP, HEMI-, FEMORAL, METAL/POLYMER, CEMENTED OR UNCEMENTED |
Manufacturer (Section D) |
|
MDR Report Key | 18318162 |
MDR Text Key | 330639658 |
Report Number | MW5149169 |
Device Sequence Number | 1 |
Product Code |
KWY
|
Combination Product (y/n) | Y |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
12/01/2023 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 12/12/2023 |
Patient Sequence Number | 1 |
Treatment | AMLODIPINE 5MG QD.; B COMPLEX.; CALCIUM.; CELEBREX 100MG PRN ARTHRITIS.; MAGNESIUM.; NSAIDS (NON-STEROIDAL ANTI-INFLAMMATORY DRUGS); PLAVIX 75MG QD.; RECLAST INFUSION LAST DONE JUNE 2023.; REPATHA 140 SQ EVERY 3 WEEKS (CHOLESTEROL).; TYLENOL 500X 2 HS ARTHRITIS.; VALTREX 500 MG (GENERIC) PREVENTIVE HSV Q DAY.; VITAMIN D HERBAL REMEDIES BEING USED.; XIIDRA BID EYES DROPS. |
Patient Outcome(s) |
Disability;
|
Patient Age | 73 YR |
Patient Sex | Female |
Patient Weight | 73 KG |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|