BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MG PATELLA

    MDR report key: 34189 · Received June 26, 1996

    Report

    Report Number
    33141-1996-00017
    Event Type
    Injury
    Date Received
    June 26, 1996
    Date of Event
    April 25, 1996
    Report Date
    June 24, 1996
    Manufacturer
    ZIMMER, INC.
    Product Code
    HTG
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IN, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PT COMPLAINED OF PAIN. IT WAS FOUND THAT THE PLASTIC HAD SEPARATED FROM THE METAL. THE PATELLA WAS REPLACED WITH A 00-5220-013-00.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MG PATELLA Implant PATELLA HTG ZIMMER, INC. UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Required Intervention