FDA Adverse Event Injury Summary report: N

ZIMMER

MDR report key: 22644 · Received January 25, 1995

Report

Report Number
33141-1995-00001
Event Type
Injury
Date Received
January 25, 1995
Date of Event
January 5, 1995
Report Date
January 6, 1995
Manufacturer
ZIMMER
Product Code
HTG
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT COMPLAINED OF PAIN. IT WAS FOUND THAT THE PLASTIC HAD SEPARATED FROM THE METAL. THE MGI PATELLA WAS REPLACED WITH A 00-5220-012-00.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZIMMER Implant MG PATELLA HTG ZIMMER 60552100

Patients

Seq Age Sex Outcome Treatment
1 88 YR Required Intervention