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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH RESTORATION ANATOMIC SHELL SIZE 68 RIGHT; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED

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STRYKER ORTHOPAEDICS-MAHWAH RESTORATION ANATOMIC SHELL SIZE 68 RIGHT; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED Back to Search Results
Catalog Number 504-02-68F-R
Device Problems Packaging Problem (3007); Component Misassembled (4004)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 06/04/2019
Event Type  malfunction  
Manufacturer Narrative
Review of the product history records indicate devices were manufactured and accepted into final stock with no relevant reported discrepancies.There have been no other events for the lot referenced.Device evaluation is anticipated but not yet begun.A supplemental report will be submitted upon completion of the investigation.
 
Event Description
Upon incoming inspection it was noticed that the implants were loose in packaging.Implants have been shipped to the decon lab.No further information available.
 
Manufacturer Narrative
An event regarding a packaging issue involving a restoration shell was reported.The event was confirmed following visual inspection of the returned part.Method & results: device evaluation and results: visual inspection was performed and it was identified that there was damage caused to the blister walls and the implant.Material analysis, functional and dimensional inspections were not completed as these aspects are not in question.Material analysis, functional and dimensional inspections were not completed as these aspects are not in question.Clinician review: no medical records were received for review with a clinical consultant.Device history review: all devices were manufactured and accepted into final stock with no relevant reported discrepancies.Complaint history review: there have been no other similar events for the reported lot.Conclusion: nc was raised on (b)(6) 2019 to evaluate the root cause, which indicates that due to misplacement of the implant from the post, the implant is free to move around in the blister.This causes the rough surface of the implant to abrade the petg blister walls causing debris.The hazard related to this packaging issue results in the implant disassociating from its post within the packaging prior to surgery, ultimately leading to the patient being exposed to excessive coating debris/unintended foreign object (petg and tpu packaging particulates).
 
Event Description
Upon incoming inspection it was noticed that the implants were loose in packaging.Implants have been shipped to the decon lab.No further information available.
 
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Brand Name
RESTORATION ANATOMIC SHELL SIZE 68 RIGHT
Type of Device
PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED
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
collin neitzel
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key8748270
MDR Text Key149649275
Report Number0002249697-2019-02431
Device Sequence Number1
Product Code LPH
UDI-Device Identifier07613327012514
UDI-Public07613327012514
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K151264
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 11/26/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date09/30/2021
Device Catalogue Number504-02-68F-R
Device Lot NumberDA1ATY
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/11/2018
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 06/04/2019
Initial Date FDA Received07/01/2019
Supplement Dates Manufacturer Received10/29/2019
Supplement Dates FDA Received11/26/2019
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/20/2016
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) Other;
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