FDA Adverse Event Malfunction Summary report: N

NEXGEN LPS-FLEX ARTICULAR SURFACE

MDR report key: 2090212 · Received April 11, 2011

Report

Report Number
1822565-2011-00891
Event Type
Malfunction
Date Received
April 11, 2011
Date of Event
June 2, 2010
Report Date
June 8, 2010
Manufacturer
ZIMMER, INC.
Product Code
JWH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFO WAS RECEIVED FROM A DISTRIBUTOR WHO IS NOT REQUIRED TO COMPLETE FORM 3500A. THIS MDR WAS IDENTIFIED DURING AN INTERNAL REVIEW TO MEET REPORTING REQUIREMENTS AND THEREFORE IS BEING FILED LATE. THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT THE TOP FOIL LAYER OF THE PACKAGING WAS NOT SEALED. ANOTHER DEVICE WAS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN LPS-FLEX ARTICULAR SURFACE JWH ZIMMER, INC. 61387710

Patients

Seq Age Sex Outcome Treatment
1