BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER SELF TAPPING BONE SCREW

    MDR report key: 28006 · Received August 15, 1995

    Report

    Report Number
    34546-1995-00002
    Event Type
    Injury
    Date Received
    August 15, 1995
    Date of Event
    August 9, 1995
    Report Date
    August 10, 1995
    Manufacturer
    ZIMMER
    Product Code
    HWC
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THREE OF FOUR CORTICAL SCREWS FRACTURED. THESE WERE PART OF A COMPRESSION HIP SCREW ASSEMBLY. #1181-140-04 TUBE/PLATE 58720500. #1181-015-35 LAG SCREW 79067900.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER SELF TAPPING BONE SCREW Implant BONE SCREW HWC ZIMMER NA UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention