BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER, INC.

    MDR report key: 150092 · Received February 20, 1998

    Report

    Report Number
    32771-1998-00001
    Event Type
    Injury
    Date Received
    February 20, 1998
    Date of Event
    February 4, 1998
    Report Date
    February 19, 1998
    Manufacturer
    ZIMMER, INC.
    Product Code
    KWB
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    HGP I LINER DISLOCATED FROM METAL BACKED ACETABULAR CUP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER, INC. Implant HGP I CUP/LINER 28 X 56MM KWB ZIMMER, INC. * 72692800

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Required Intervention