FDA Adverse Event Malfunction Summary report: N

ZIMMER ZNN CALIBRATED DRILL CANNULATED

MDR report key: 2093268 · Received May 3, 2011

Report

Report Number
1822565-2011-01103
Event Type
Malfunction
Date Received
May 3, 2011
Date of Event
March 21, 2011
Report Date
April 4, 2011
Manufacturer
ZIMMER INC.
Product Code
HTW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED FROM A DISTRIBUTOR WHO IS NOT REQUIRED TO COMPLETE FORM 3500A. THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT WHILE DRILLING OVER THE GUIDE PIN, THE DRILL BIT FRACTURED. AFTER SURGERY AN X-RAY DETERMINED THAT THE FRACTURED PORTION OF THE DEVICE REMAINS IN THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZIMMER ZNN CALIBRATED DRILL CANNULATED HTW ZIMMER INC. 61581731

Patients

Seq Age Sex Outcome Treatment
1