BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CENTRALIGN 2.5 FEM STEM

    MDR report key: 350462 · Received September 5, 2001

    Report

    Report Number
    1822565-2001-00069
    Event Type
    Injury
    Date Received
    September 5, 2001
    Date of Event
    June 26, 2001
    Manufacturer
    ZIMMER, INC.
    Product Code
    KWY
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    CENTRALIGN FEMORAL COMPONENT LOOSENED AND WAS REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    40214 CENTRALIGN 2.5 FEM STEM KWY ZIMMER, INC. NA 07848300

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Hospitalization| R