FDA Adverse Event Injury Summary report: N

ZIMMER FEMORAL STEM W/ KINECTIV TECHNOLOGY

MDR report key: 2013371 · Received March 8, 2011

Report

Report Number
1822565-2011-00497
Event Type
Injury
Date Received
March 8, 2011
Report Date
February 8, 2011
Manufacturer
ZIMMER, INC.
Product Code
LPH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

INFO WAS RECEIVED FROM A CONSUMER WHO IS NOT REQUIRED TO COMPLETE FORM 3500A. EVAL SUMMARY: THE EXACT ORIGIN OF THE PAIN IS UNK. NO DEVICES OR PHOTOS WERE RECEIVED, THEREFORE THE CONDITION OF THE COMPONENTS IS UNK. SURGICAL NOTES WERE NOT PROVIDED. X-RAYS WERE NOT PROVIDED; IT IS UNK WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. PT FACTORS THAT MAY AFFECT THE PERFORMANCE OF THE COMPONENTS SUCH AS AGE, BONE QUALITY, HEIGHT/WEIGHT, ACTIVITY LEVEL, TYPE OF ACTIVITY (LOW IMPACT VS. HIGH IMPACT) ARE UNK. THERE IS INSUFFICIENT INFO TO PERFORM A PROBABLE CAUSE ANALYSIS. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFO PROVIDED. EVAL: REVIEW OF THE DEVICE HISTORY RECORDS DID NOT FIND ANY DEVIATIONS OR ANOMALIES. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADD'L SUBSTANTIVE INFO BE RECEIVED, THE COMPLAINT WILL BE REOPENED. ZIMMER, INC. CONSIDERS THE INVESTIGATION CLOSED.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PT IS EXPERIENCING HIP PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZIMMER FEMORAL STEM W/ KINECTIV TECHNOLOGY LPH ZIMMER, INC. 60782502

Patients

Seq Age Sex Outcome Treatment
1 Other KINECTIV TECHNOLOGY MODULAR NECK:| CATALOG # 00784800200, LOT # 60778048