BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KINECTIV TECHNOLOGY MODULAR NECK

    MDR report key: 1940900 · Received December 23, 2010

    Report

    Report Number
    1822565-2010-01465
    Event Type
    Injury
    Date Received
    December 23, 2010
    Date of Event
    December 14, 2010
    Report Date
    December 3, 2010
    Manufacturer
    ZIMMER INC
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    IT IS REPORTED THAT THE PT WAS REVISED DUE TO FRACTURE OF THE KINECTIV MODULAR NECK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KINECTIV TECHNOLOGY MODULAR NECK HIP PROSTHESIS JDI ZIMMER INC 60940137

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention