FDA Adverse Event Injury Summary report: N

NEXGEN LCCK ARTICULAR SURFACE

MDR report key: 2220292 · Received August 16, 2011

Report

Report Number
1822565-2011-01884
Event Type
Injury
Date Received
August 16, 2011
Date of Event
July 8, 2011
Report Date
July 20, 2011
Manufacturer
ZIMMER, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

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 THE PT WAS REVISED FOR A LOCKING SCREW THAT BACKED OUT OF THE ARTICULAR SURFACE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 55 YR Required Intervention