inforMED
InjuryPKC

DJO SURGICAL

Received Dec 10, 2024 · Event occurred Nov 14, 2024

Report 1644408-2024-01915 · MDR key 20898984

Device

Generic name

Altivate Anatomic Cs, Humeral Stem And Neck Kit, Size 2

Catalog number

520-08-021

Lot number

1991A1165

Product problems

  • Unstable
  • Adverse Event Without Identified Device or Use Problem
  • Unstable
  • Adverse Event Without Identified Device or Use Problem

Patient

64 YR · Female

  • Joint Dislocation
  • Joint Dislocation

Narrative

Additional Manufacturer Narrative

SEE H6, H10, AND H11. COMPLAINT HAS BEEN EVALUATED AND IS SIMILAR TO REPORT NUMBER 1644408-2022-00807; 520-08-021, S803 - DISLOCATION, REVISION SURGERY. IF ADDITIONAL INFORMATION REGARDING THE REPORTED EVENT IS SUBMITTED AT A FUTURE DATE, THIS INVESTIGATION WILL BE RE-EVALUATED.

Description of Event or Problem

REVISION SURGERY DUE TO PATIENT DISLOCATION.

Additional Manufacturer Narrative

ADDITIONAL REPORTING ON THIS EVENT WILL BE PROVIDED AS A SUPPLEMENTAL REPORT TO THIS DOCUMENT AS SOON AS IT BECOMES AVAILABLE.