FDA Adverse Event
Injury
Summary report: N
VISTA-S ANGELED DEVICE 14X14, 5MM (RED)
MDR report key: 2872539
·
Received December 5, 2012
Report
- Report Number
- 3005751028-2012-00167
- Event Type
- Injury
- Date Received
- December 5, 2012
- Date of Event
- November 2, 2012
- Report Date
- December 5, 2012
- Manufacturer
- ZIMMER TRABECULAR METAL TECHNOLOGY
- Product Code
- JWH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT AN IMPLANT WAS ACCIDENTALLY IMPLANTED. PRODUCT EXPIRATION DATE ON PACKAGE WAS 07/31/2012.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | VISTA-S ANGELED DEVICE 14X14, 5MM (RED) | VISTA S | JWH | ZIMMER TRABECULAR METAL TECHNOLOGY | 60769205 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |