BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VERSYS FEMORAL HEAD

    MDR report key: 2932178 · Received January 25, 2013

    Report

    Report Number
    1822565-2013-00182
    Event Type
    Injury
    Date Received
    January 25, 2013
    Date of Event
    December 27, 2012
    Report Date
    December 27, 2013
    Manufacturer
    ZIMMER, INC.
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, 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 LOOSENING, OSTEOLYSIS, PAIN AND TRUNNION WEAR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36311 VERSYS FEMORAL HEAD LPH ZIMMER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention