FDA Adverse Event
Injury
Summary report: N
UNKNOWN ZIMMER SEGMENTAL KNEE
MDR report key: 2890764
·
Received December 21, 2012
Report
- Report Number
- 1822565-2012-02619
- Event Type
- Injury
- Date Received
- December 21, 2012
- Date of Event
- November 20, 2012
- Report Date
- November 30, 2012
- Manufacturer
- ZIMMER INC
- Product Code
- JWH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- 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 WAS REVISED DUE TO INFECTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNKNOWN ZIMMER SEGMENTAL KNEE | KNEE PROSTHESIS | JWH | ZIMMER INC |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 68 YR | Required Intervention |