FDA Adverse Event Malfunction Summary report: N

ZMR HIP SYSTEM TAPER STEM

MDR report key: 2142132 · Received May 26, 2011

Report

Report Number
1822565-2011-01240
Event Type
Malfunction
Date Received
May 26, 2011
Date of Event
April 22, 2011
Report Date
April 28, 2011
Manufacturer
ZIMMER, INC.
Product Code
LPH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
OTHER

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 UPON OPENING THE STEM, IT WAS FOUND PROTRUDING THROUGH THE INNER AND OUTER PACKAGING. THE SURGEON REAMED UP AND IMPLANTED A LARGER SIZE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZMR HIP SYSTEM TAPER STEM LPH ZIMMER, INC. 60079888

Patients

Seq Age Sex Outcome Treatment
1