FDA Adverse Event Injury Summary report: N

NATURAL KNEE SYSTEM POLY PATELLA STOP DRILL

MDR report key: 1841526 · Received September 14, 2010

Report

Report Number
1822565-2010-00690
Event Type
Injury
Date Received
September 14, 2010
Date of Event
August 11, 2010
Report Date
August 11, 2010
Manufacturer
ZIMMER INC.
Product Code
HTW
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT THE STOP ON THE DRILL BIT IS NOT ENGAGING WHICH COULD ALLOW THE SURGEON TO COMPLETELY DRILL THROUGH THE PATELLA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NATURAL KNEE SYSTEM POLY PATELLA STOP DRILL KNEE INSTRUMENT HTW ZIMMER INC. 61015149

Patients

Seq Age Sex Outcome Treatment
1 90 YR Other NATURAL KNEE SYSTEM PETALLA BUSHING| LOT #61040228, CATALOG #629000750| NATURAL KNEE SYSTEM POLY PATELLA DRILL GUIDE| LOT #0796408, CATALOG #629000690