BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ZIMMER TRABECULAR METAL SHOULDER PIN

    MDR report key: 2021397 · Received February 8, 2011

    Report

    Report Number
    1822565-2011-00211
    Event Type
    Malfunction
    Date Received
    February 8, 2011
    Date of Event
    January 13, 2011
    Report Date
    January 13, 2011
    Manufacturer
    ZIMMER, INC.
    Product Code
    HTY
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    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 PINS BROKE AT THE TIP OF THE THREAD DURING INSERTION INTO THE GLENOID.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER TRABECULAR METAL SHOULDER PIN HTY ZIMMER, INC. 61594738

    Patients

    Seq Age Sex Outcome Treatment
    1 CAT # 47430902500, LOT #61594738| SYSTEM INSTRUMENTATION PIN| ZIMMER TRABECULAR METAL REVERSE SHOULDER