BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER

    MDR report key: 224624 · Received May 21, 1999

    Report

    Report Number
    1822565-1999-00064
    Event Type
    Injury
    Date Received
    May 21, 1999
    Date of Event
    June 23, 1997
    Report Date
    May 17, 1999
    Manufacturer
    ZIMMER, INC.
    Product Code
    JDG
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DEVICE WAS IMPLANTED IN LEFT HIP ON 1/5/1995. ON 6/23/1997, PATIENT DIESCOVERED THAT THE DEVICE HAD DEBONDED. IT IS UNKNOWN WHETHER DEVICE HAS BEEN REVISED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER Implant CENTRALIGN PRECT HIP FEM STEM JDG ZIMMER, INC. NA 59760100

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention