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