BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACETABULAR AUGMENT

    MDR report key: 2200733 · Received July 26, 2011

    Report

    Report Number
    3005751028-2011-00051
    Event Type
    Injury
    Date Received
    July 26, 2011
    Date of Event
    June 3, 2009
    Report Date
    July 25, 2011
    Manufacturer
    ZIMMER TMT
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    LIMITED INFO IS AVAILABLE AT THIS TIME. ROOT CAUSE AND FURTHER DETAILS ON THE EVENT ARE NOT AVAILABLE FOR REVIEW. SHOULD ADDITIONAL INFO BE RECEIVED WHICH WILL FURTHER THIS INVESTIGATION THIS REPORT SHALL BE UPDATED.

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE PT'S COUNSEL THAT THE PT UNDERWENT A TOTAL LEFT HIP ARTHROPLASTY ON (B)(6) 2007. THE PT EXPERIENCED PAIN IN HIS HIP, BUTTOCK, SCIATIC NERVE AND LEFT LEG. A REVISION WAS PERFORMED ON (B)(6) 2009. IT WAS NOTED THAT HE SUFFERED FROM AN IMPINGEMENT OF HIS SCIATIC NERVE BY HIS LEFT PIRIFORMIS MUSCLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACETABULAR AUGMENT AUGMENT LPH ZIMMER TMT 60554684

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention