FDA Adverse Event Malfunction Summary report: N

TRILOGY BONE SCREW SELF-TAPPING

MDR report key: 1372282 · Received February 19, 2009

Report

Report Number
2648920-2009-00003
Event Type
Malfunction
Date Received
February 19, 2009
Date of Event
January 7, 2009
Report Date
January 9, 2009
Manufacturer
ZIMMER MANUFACTURING B.V.
Product Code
JDI
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT DURING SURGERY IN EARLY 2009, THE STERILE PACKAGING CAME OFF WITH OUTSIDE PEEL OFF COVER. THEREFORE, POSSIBLY CONTAMINATING STERILE SCREW. THE SCREW WAS NOT IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRILOGY BONE SCREW SELF-TAPPING HIP PROSTHESIS JDI ZIMMER MANUFACTURING B.V. NA 60610643

Patients

Seq Age Sex Outcome Treatment
1 UNK