BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER.COM

    MDR report key: 1931374 · Received December 7, 2010

    Report

    Report Number
    MW5018592
    Event Type
    Injury
    Date Received
    December 7, 2010
    Date of Event
    August 21, 2007
    Report Date
    December 3, 2010
    Product Code
    JDI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    RT HIP BROKEN - TOTAL HIP REPLACEMENT 2007. PAIN SINCE SURGERY TIL 2010. ANOTHER SURGERY SCHEDULED FOR (B)(6) 2010 (REVISION).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER.COM TOWER FOR HIP REPLACEMENT JDI

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Required Intervention| S