BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NEXGEN PROLONG LPS-FLEX ARTICULAR SURFACE

    MDR report key: 3002331 · Received March 7, 2013

    Report

    Report Number
    1822565-2013-00453
    Event Type
    Malfunction
    Date Received
    March 7, 2013
    Date of Event
    November 12, 2012
    Report Date
    December 27, 2012
    Manufacturer
    ZIMMER, INC.
    Product Code
    JWH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    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 THE SURGEON WAS UNABLE TO PROPERLY LOCK THE ARTICULAR SURFACE INTO PLACE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    97261 NEXGEN PROLONG LPS-FLEX ARTICULAR SURFACE JWH ZIMMER, INC. 62108912

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR