BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER

    MDR report key: 146516 · Received January 28, 1998

    Report

    Report Number
    33141-1998-00008
    Event Type
    Injury
    Date Received
    January 28, 1998
    Date of Event
    January 27, 1998
    Report Date
    January 28, 1998
    Manufacturer
    ZIMMER, INC.
    Product Code
    HTG
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IN, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THE PT NOTICED A SQUEAKING NOISE IN HIS KNEE. IT WAS FOUND THAT THE PLASTIC HAD WORN THROUGH TO THE METAL. THE MG I PATELLA WAS REPLACED WITH A 00-5220-014-00, LOT # 14053900. THE MG I PATELLA WAS A WHITE POROUS IMPLANT. THE HOSP RELEASED THE DEVICE TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER Implant MG PATELLA HTG ZIMMER, INC. NA 67207800

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention