BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MG PATELLA

    MDR report key: 28193 · Received October 27, 1995

    Report

    Report Number
    33141-1995-00024
    Event Type
    Injury
    Date Received
    October 27, 1995
    Date of Event
    October 16, 1995
    Report Date
    October 24, 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 PATELLA WAS REPLACED WITH A 00-5220-012-0.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention