BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRILOGY ACETABULAR SHELL WITHOUT HOLES

    MDR report key: 2222862 · Received August 10, 2011

    Report

    Report Number
    2648920-2011-00042
    Event Type
    Malfunction
    Date Received
    August 10, 2011
    Date of Event
    April 12, 2011
    Report Date
    July 13, 2011
    Manufacturer
    ZIMMER,
    Product Code
    LPH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    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 SCRUB NURSE OPENED THE IMPLANT AND FOUND THAT THE IMPLANT HAD A DEFECT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRILOGY ACETABULAR SHELL WITHOUT HOLES LPH ZIMMER, 61452212

    Patients

    Seq Age Sex Outcome Treatment
    1