FDA Adverse Event Injury Summary report: N

NEXGEN LPS ARTICULAR SURFACE

MDR report key: 2871510 · Received December 6, 2012

Report

Report Number
1822565-2012-02490
Event Type
Injury
Date Received
December 6, 2012
Date of Event
October 26, 2012
Report Date
November 9, 2012
Manufacturer
ZIMMER, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT HAD A LARGE AMOUNT OF KNEE SWELLING AND LOCALIZED PAIN POSTERIORLY. THE PT UNDERWENT ASPIRATION AND 50CC OF PURULENT FLUID WAS TAKEN FROM THE KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN LPS ARTICULAR SURFACE JWH ZIMMER, INC. 60334226

Patients

Seq Age Sex Outcome Treatment
1 79 YR Required Intervention NEXGEN OFFSET STEM EXTENSION:| CATALOG #00598801017, LOT #60939637| NEXGEN STEMMED TIBIAL COMPONENT:| NEXGEN ANTERIOR FEMORAL AUGMENT BLOCK:| MANUFACTURED AT ZIMMER (B)(4)| NEXGEN STRAIGHT STEM EXTENSION:| (B)(4)| NEXGEN LCCK FEMORAL COMPONENT:| CATALOG #00599401692, LOT #61411989| MANUFACTURED AT ZIMMER (B)(4)| CATALOG #00598802016, LOT #61285534| CATALOG #00598005701, LOT #61307736| NEXGEN ALL POLY PATELLA: CATALOG #00597206541,| CATALOG #00599003631, LOT #60785664| LOT #61407366, MANUFACTURED AT ZIMMER