BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VERSYS FEMORAL HEAD

    MDR report key: 3802448 · Received February 21, 2014

    Report

    Report Number
    2648920-2014-00030
    Event Type
    Malfunction
    Date Received
    February 21, 2014
    Date of Event
    January 22, 2014
    Report Date
    January 23, 2014
    Manufacturer
    ZIMMER
    Product Code
    JDI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER

    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 HEAD WOULD NOT MATE WITH THE TAPER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    110392 VERSYS FEMORAL HEAD JDI ZIMMER 62508449

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR