MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH UNKNOWN LFIT ANATOMIC COCR V40 FEMORAL HEAD; HIP IMPLANT

Catalog Number UNK_JR

Device Problems Corroded (1131); Material Discolored (1170)

Patient Problems Death (1802); Edema (1820); Unspecified Infection (1930); Necrosis (1971); Pain (1994); Injury (2348)

Event Date 01/08/2015

Event Type  Injury  

Manufacturer Narrative

The information in this report was provided by stryker orthopaedics legal affairs department.No additional information is available at this time due to the ongoing litigation.Should additional information become available, the evaluation summary will be submitted in a supplemental report.

Event Description

It was reported through the filing of a lawsuit that allegedly the patient began to experience pain and was evaluated by her physicians.She underwent revision surgery on (b)(6) 2015 and during this procedure, the surgeon "found significant necrosis and fluid within the hip and gluteus minimus.As he performed the procedure, he encountered additional necrosis within the abductors and soft tissue, and there was corrosion and black staining under the ball and surrounding taper." it is further alleged that on (b)(6) 2015 as a direct and proximate result of a post-operative infection that developed after revision surgery, the patient died.

• Brand Name: UNKNOWN LFIT ANATOMIC COCR V40 FEMORAL HEAD
• Type of Device: HIP IMPLANT
• 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: timothy rice ; 325 corporate drive; mahwah, NJ 07430 ; 2018315000
• MDR Report Key: 7483614
• MDR Text Key: 107245201
• Report Number: 0002249697-2018-01328
• Device Sequence Number: 1
• Product Code: LZO
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer,other
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 05/03/2018

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/03/2018
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: UNK_JR
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 04/05/2018
• 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 Number: 1
• Patient Outcome(s): Death