BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER PERIARTICULAR LOCKING PLATE SCREW

    MDR report key: 1980208 · Received February 1, 2011

    Report

    Report Number
    1822565-2011-00146
    Event Type
    Injury
    Date Received
    February 1, 2011
    Date of Event
    December 16, 2010
    Report Date
    January 4, 2011
    Manufacturer
    ZIMMER, INC.
    Product Code
    HWC
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SN
    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 LOCKING SCREWS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER PERIARTICULAR LOCKING PLATE SCREW HWC ZIMMER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention CATALOG #00235905045, LOT #UNK| CATALOG #00235906045, LOT #UNK| ZIMMER PERIARTICULAR LOCKING PLATE SCREW| ZIMMER PERIARTICULAR LOCKING PLATE SCREW| CATALOG #00235907045, LOT #UNK| ZIMMER PERIARTICULAR LOCKING PLATE SCREW| CATALOG #00235904045, LOT #UNK| ZIMMER PERIARTICULAR LOCKING PLATE SCREW