BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TOTAL HIP PROSTHESIS

    MDR report key: 30521 · Received January 4, 1996

    Report

    Report Number
    30521
    Event Type
    Injury
    Date Received
    January 4, 1996
    Date of Event
    April 17, 1995
    Report Date
    July 24, 1995
    Manufacturer
    ZIMMER, INC.
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT HAD LEFT TOTAL HIP REPLACEMENT 10/11/93. ADMITTED 2/12/95 WITH DISLOCATION OF LEFT HIP. PT WAS BENDING OVER DUSTING FURNITURE WHEN DISLOCATION OCCURRED. CLOSED REDUCTION OF LEFT HIP DONE. 3/8/95 ADMITTED WITH DISLOCATION OF LEFT HIP PROSTHESIS. CLOSED REDUCTION DONE. 4/17/95 ADMITTED WITH DISLOCATION LEFT HIP PROSTHESIS. CLOSED REDUCTION DONE. ADD'L CAT # 6624-65-25, 6728-87, 9026-28, 6630-13. ADD'L LOT # 44242600, 48809700, 43744900.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TOTAL HIP PROSTHESIS Implant TOTAL HIP PROSTHESIS JDI ZIMMER, INC. 43676600, 41480300, 47748600

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Hospitalization| R