FDA Adverse Event Injury Summary report: N

ZIMMER M/L TAPER FEMORAL STEM

MDR report key: 3093694 · Received May 1, 2013

Report

Report Number
1822565-2013-00727
Event Type
Injury
Date Received
May 1, 2013
Date of Event
January 21, 2012
Report Date
April 1, 2013
Manufacturer
ZIMMER INC
Product Code
LZO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
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 PATIENT WAS EXPERIENCING PAIN. UPON EXAMINATION, IT WAS NOTED THAT THE STEM POSITION HAD CHANGED. THE PATIENT WAS REVISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
189585 ZIMMER M/L TAPER FEMORAL STEM LZO ZIMMER INC 61925459

Patients

Seq Age Sex Outcome Treatment
1 70 YR Required Intervention