BEUDAMED
    FDA Adverse Event Death Summary report: N

    ZIMMER

    MDR report key: 229827 · Received June 29, 1999

    Report

    Report Number
    MW1016639
    Event Type
    Death
    Date Received
    June 29, 1999
    Date of Event
    April 6, 1999
    Report Date
    June 21, 1999
    Manufacturer
    ZIMMER, INC.
    Product Code
    HWC
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    COMPRESSION PIN (SCREW) COMPONENT OF ZIMMER SCREW/PLATE DISLODGED FROM PLATE MONTHS AFTER HIP REPLACEMENT AND DAMAGED PELVIC VESSELS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER Implant HEX HEAD COMPRESSION SCREW HWC ZIMMER, INC. * 15893800
    2 ZIMMER Implant FREE LOCK FEMORAL HIP FIXATION SYSTEM HRS ZIMMER, INC. * 19051800
    3 ZIMMER Implant COMPRESSION LAG SCREW HWC ZIMMER, INC. * 15634700

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Death