FDA Adverse Event Injury Summary report: N

UNK COONRAD/MORREY ULNA

MDR report key: 1113151 · Received August 12, 2008

Report

Report Number
1822565-2008-00512
Event Type
Injury
Date Received
August 12, 2008
Date of Event
September 17, 2005
Report Date
July 2, 2008
Manufacturer
ZIMMER, INC.
Product Code
JDB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

WE COULD NOT OBTAIN A COMPLETE CATALOG NUMBER; THEREFORE, A BASELINE REPORT CANNOT BE FILED. THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PT WAS REVISED AT THE CLINIC. IMPLANT DATE WAS 2005 AND EXPLANT DATE IS UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNK COONRAD/MORREY ULNA ELBOW PROSTHESIS JDB ZIMMER, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization| R