BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ZIMMER ZNN THREADED PIN

    MDR report key: 2943201 · Received January 21, 2013

    Report

    Report Number
    1822565-2013-00122
    Event Type
    Malfunction
    Date Received
    January 21, 2013
    Date of Event
    December 12, 2012
    Report Date
    December 22, 2012
    Manufacturer
    ZIMMER, INC.
    Product Code
    LXH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    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 IS REPORTED THAT TWO THREADED PINS WERE BROKEN WHEN INSERTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    28677 ZIMMER ZNN THREADED PIN LXH ZIMMER, INC. 62091638

    Patients

    Seq Age Sex Outcome Treatment
    1 ZIMMER ZNN THREADED PIN: CATALOG# 00249004630,| LOT# 62091638