FDA Adverse Event Injury Summary report: N

NEXGEN CRUCIATE RETAINING ARTICULAR SURFACE

MDR report key: 2860485 · Received December 5, 2012

Report

Report Number
1822565-2012-02475
Event Type
Injury
Date Received
December 5, 2012
Date of Event
November 18, 2010
Report Date
November 6, 2012
Manufacturer
ZIMMER, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PATIENT HAD A MANIPULATION UNDER ANESTHESIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN CRUCIATE RETAINING ARTICULAR SURFACE JWH ZIMMER, INC. 60783239

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention MANUFACTURED BY ZIMMER (B)(4)| NEXGEN ALL POLY PATELLA| CATALOG #00597002502, LOT #60917547| CATALOG #00575001606, LOT #61174949| NEXGEN CR-FLEX GSF FEMORAL COMPONENT| NEXGEN CRUCIATE RETAINING TIBIAL COMPONENT| CATALOG #00597206535, LOT #61169305