BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN ZIMMER PATELLA

    MDR report key: 1960991 · Received January 11, 2011

    Report

    Report Number
    1822565-2011-00027
    Event Type
    Injury
    Date Received
    January 11, 2011
    Date of Event
    December 8, 2010
    Report Date
    December 8, 2010
    Manufacturer
    ZIMMER, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    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 FOR PAIN. AFTER EXPOSURE, THE PATELLA WAS FOUND TO BE LOOSE AND FREE-FLOATING WITHIN THE JOINT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN ZIMMER PATELLA KNEE PROSTHESIS JWH ZIMMER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR