FDA Adverse Event
Injury
Summary report: N
UNKNOWN COONRAD/MORREY ELBOW
MDR report key: 1915692
·
Received December 1, 2010
Report
- Report Number
- 1822565-2010-01240
- Event Type
- Injury
- Date Received
- December 1, 2010
- Date of Event
- July 28, 2008
- Report Date
- November 4, 2010
- Manufacturer
- ZIMMER, INC.
- Product Code
- JDC
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVALUATION SUMMARY: NO PRODUCT, PART IDENTIFICATION, OR X-RAYS WERE PROVIDED. AN EXACT CAUSE CANNOT BE DETERMINED WITH CERTAINTY. EVALUATION: REVIEW OF THE DEVICE HISTORY RECORDS WAS ALSO NOT POSSIBLE AS THE PRODUCT AND/OR LOT NUMBERS REQUIRED FOR RETRIEVAL WERE UNAVAILABLE. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. BASED ON THE AVAILABLE INFORMATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADDITIONAL SUBSTANTIVE INFORMATION BE RECEIVED, THE COMPLAINT WILL BE REOPENED. ZIMMER, INC. CONSIDERS THE INVESTIGATION CLOSED.
Description of Event or Problem · 1
IT IS REPORTED THAT THE PATIENT WAS REVISED FOR PAIN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNKNOWN COONRAD/MORREY ELBOW | ELBOW PROSTHESIS | JDC | ZIMMER, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 65 YR | Required Intervention |