BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AGC-S MOD. TIB. BEARING

    MDR report key: 266638 · Received February 29, 2000

    Report

    Report Number
    1825034-2000-00009
    Event Type
    Injury
    Date Received
    February 29, 2000
    Date of Event
    November 30, 1999
    Report Date
    February 28, 2000
    Manufacturer
    BIOMET, INC.
    Product Code
    JWH
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FI
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    TOTAL KNEE ARTHROPLASTY PERFORMED 1994. REVISION PERFORMED 1999, DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AGC-S MOD. TIB. BEARING PROSTHESIS, KNEE, COMP JWH BIOMET, INC. NA 085590

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Hospitalization| R