BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN TRILOGY IMPLANT

    MDR report key: 3242954 · Received July 19, 2013

    Report

    Report Number
    1822565-2013-01123
    Event Type
    Injury
    Date Received
    July 19, 2013
    Report Date
    June 21, 2013
    Manufacturer
    ZIMMER, INC.
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SURGICAL NOTES WERE NOT PROVIDED. X-RAYS WERE NOT PROVIDED; IT IS UNKNOWN WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. PATIENT FACTORS THAT MAY AFFECT THE PERFORMANCE OF THE COMPONENTS SUCH AS AGE, BONE QUALITY, HEIGHT/WEIGHT, ACTIVITY LEVEL, TYPE OF ACTIVITY (LOW IMPACT VS. HIGH IMPACT), AND RELEVANT MEDICAL HISTORY ARE UNKNOWN. ADHERENCE TO REHABILITATION PROTOCOL IS UNKNOWN. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFORMATION PROVIDED. EVALUATION CODES: REVIEW OF THE DEVICE HISTORY RECORDS WAS NOT POSSIBLE AS THE PRODUCT AND/OR LOT NUMBERS REQUIRED FOR RETRIEVAL WERE UNAVAILABLE. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. BASED ON THE AVAILABLE INFORMATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADDITIONAL SUBSTANTIVE INFORMATION BE RECEIVED, THE COMPLAINT WILL BE REOPENED. ZIMMER, INC. CONSIDERS THE INVESTIGATION CLOSED.

    Description of Event or Problem · 1

    IT IS REPORTED THAT UNKNOWN INJURIES OCCURRED IN (B)(6) 2010, WHERE THE PATIENT SUFFERED SEVERE AND CHRONIC PAIN, AND LIMITED MOBILITY AMONG OTHER PHYSICAL AND MENTAL AILMENTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    339019 UNKNOWN TRILOGY IMPLANT HIP PROSTHESIS LPH ZIMMER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 Other UNK VERSYS FEMORAL STEM, CATALOG #UNK, LOT #UNK