BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TM MONOBLOCK TIBIA

    MDR report key: 2200749 · Received July 26, 2011

    Report

    Report Number
    3005751028-2011-00055
    Event Type
    Injury
    Date Received
    July 26, 2011
    Report Date
    July 26, 2011
    Manufacturer
    ZIMMER TMT
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    AT THE PRESENT TIME, THERE IS VERY LITTLE INFO AVAILABLE. THE IDENTIFICATION OF THE IMPLANT IS UNK AND IT REMAINS IMPLANTED. THERE IS NO REVISION SURGERY SCHEDULED AND IT IS UNK IF ONE IS PLANNED.

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE PT THAT HE IS EXPERIENCING PAIN IN THE LEFT KNEE. AT THIS TIME THERE HAS BEEN NO REVISION SURGERY AND IT IS UNK IF ONE WILL BE SCHEDULED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TM MONOBLOCK TIBIA MONOBLOCK TIBIA JWH ZIMMER TMT UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention