FDA Adverse Event Malfunction Summary report: N

NEXGEN LPS-FLEX ARTICULAR SURFACE

MDR report key: 2093566 · Received April 6, 2011

Report

Report Number
1822565-2011-00866
Event Type
Malfunction
Date Received
April 6, 2011
Date of Event
March 1, 2011
Report Date
March 10, 2011
Manufacturer
ZIMMER, INC.
Product Code
JWH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED FROM A FOREIGN SOURCE 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 WHEN OPENING THE PACKAGING, IT WAS APPARENT THAT THE SEAL WAS NOT PROPERLY GLUED DOWN. ANOTHER ARTICULAR SURFACE WAS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN LPS-FLEX ARTICULAR SURFACE JWH ZIMMER, INC. 61597689

Patients

Seq Age Sex Outcome Treatment
1