FDA Adverse Event Injury Summary report: N

ZIMMER, INC.

MDR report key: 1228 · Received August 24, 1992

Report

Report Number
32474-1992-00002
Event Type
Injury
Date Received
August 24, 1992
Date of Event
July 23, 1992
Report Date
August 3, 1992
Manufacturer
ZIMMER, INC.
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
RI, US
Reporter Occupation
UNKNOWN

Narratives

Description of Event or Problem · 1

DISLOCATION OF A HGP II LINER FROM A HGP II SHEEL, THIS WAS REPORTED BY PHYSICIAN. THE DOCTOR WAS UNABLE TO REDUCE THE DISLOCATED LINER THEREFORE HE DID THIS SURGERY ON 7/23/9DEVICE LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: UNKNOWN. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZIMMER, INC. Implant HARRIS GALANTE POLYETHYLENE LINER ZIMMER, INC. SIZE 32MM 66184300

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention