BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER M/L TAPER FEMORAL STEM

    MDR report key: 3093696 · Received May 1, 2013

    Report

    Report Number
    1822565-2013-00729
    Event Type
    Injury
    Date Received
    May 1, 2013
    Report Date
    April 2, 2013
    Manufacturer
    ZIMMER INC
    Product Code
    LZO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, 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 IS EXPERIENCING PAIN AFTER A FALL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    189012 ZIMMER M/L TAPER FEMORAL STEM LZO ZIMMER INC 61000098

    Patients

    Seq Age Sex Outcome Treatment
    1 Other (B)(4)| LOT #61188282| THE FOLLOWING ITEMS WERE MANUFACTURED BY ZIMMER| TRILOGY SHELL WITH CLUSTER HOLES:| ZIMMER KINECTIV MODULAR NECK: CATALOG #00784802200| CATALOG #00620005822, LOT #611112448| TRILOGY LONGEVITY POLY LINER: CATALOG #00631005836| VERSYS FEMORAL HEAD: CATALOG #00801803602| LOT #61192705| LOT #60810246