BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CABLE-READY CERCLAGED CABLE

    MDR report key: 3162614 · Received March 19, 2013

    Report

    Report Number
    1822565-2013-00501
    Event Type
    Malfunction
    Date Received
    March 19, 2013
    Report Date
    February 20, 2013
    Manufacturer
    ZIMMER, INC.
    Product Code
    JDQ
    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 CABLE AND PIN FRACTURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    115073 CABLE-READY CERCLAGED CABLE TRAUMA PROSTHESIS JDQ ZIMMER, INC. 62235756

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR