BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TRABECULAR METAL ACETABULAR CUP, 28/54MM, 1

    MDR report key: 2620585 · Received June 13, 2012

    Report

    Report Number
    3005751028-2012-00079
    Event Type
    Injury
    Date Received
    June 13, 2012
    Date of Event
    June 6, 2011
    Report Date
    June 12, 2012
    Manufacturer
    ZIMMER TRABECULAR METAL TECHNOLOGY
    Product Code
    LPH
    PMA / PMN Number
    K964509
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    INVESTIGATION IN PROCESS.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PT WAS REVISED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRABECULAR METAL ACETABULAR CUP, 28/54MM, 1 TM MONOBLOCK CUP LPH ZIMMER TRABECULAR METAL TECHNOLOGY 60811321

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Required Intervention