FDA Adverse Event
Injury
Summary report: N
NEXGEN LPS-FLEX GSF FEMORAL COMPONENT
MDR report key: 3645129
·
Received February 13, 2014
Report
- Report Number
- 3007963827-2014-00004
- Event Type
- Injury
- Date Received
- February 13, 2014
- Report Date
- January 15, 2014
- Manufacturer
- ZIMMER ORTHOPEDIC MFG LTD
- Product Code
- JWH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVAL SUMMARY: NO DEVICES OR PHOTOS WERE RECEIVED; THEREFORE THE CONDITION OF THE COMPONENTS IS UNK. SURGICAL NOTES WERE NOT PROVIDED. X-RAYS WERE NOT PROVIDED; IT IS UNK WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFO PROVIDED. EVAL: THE DEVICE HISTORY RECORDS FOR THE FEMORAL AND ARTICULAR COMPONENTS WERE REVIEWED, INDICATING THE DEVICE WAS MANUFACTURED, INSPECTED, AND PACKAGED TO SPECIFICATION. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADD'L SUBSTANTIVE INFO BE RECEIVED, THE COMPLAINT WILL BE REOPENED.
Description of Event or Problem · 1
IT IS REPORTED THAT THE PATIENT IS EXPERIENCING RIGHT KNEE PAIN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 95970 | NEXGEN LPS-FLEX GSF FEMORAL COMPONENT | JWH | ZIMMER ORTHOPEDIC MFG LTD | 61885162 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other | MANUFACTURED BY ZIMMER INC. WARSAW INDIANA| NEXGEN LPS-FLEX PROLONG ARTICULAR SURFACE:| CAT # 00596203210, LOT #61749375 |