BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    M/DN CORTICAL SCREW

    MDR report key: 3061476 · Received April 10, 2013

    Report

    Report Number
    2648920-2013-00097
    Event Type
    Malfunction
    Date Received
    April 10, 2013
    Date of Event
    February 22, 2013
    Report Date
    March 11, 2013
    Manufacturer
    ZIMMER
    Product Code
    HSB
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    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 SCREW BROKE WHILE INSERTING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    148247 M/DN CORTICAL SCREW HSB ZIMMER 60985463

    Patients

    Seq Age Sex Outcome Treatment
    1