BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TRILOGY LONGEVITY CROSSLINKED POLY LINER

    MDR report key: 3820037 · Received May 14, 2014

    Report

    Report Number
    1822565-2014-00608
    Event Type
    Injury
    Date Received
    May 14, 2014
    Date of Event
    April 14, 2014
    Report Date
    April 14, 2014
    Manufacturer
    ZIMMER INC
    Product Code
    LPH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    IT WAS REPORTED THE PT WAS REVISED DUE TO DISLOCATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    288912 TRILOGY LONGEVITY CROSSLINKED POLY LINER LPH ZIMMER INC 67628200

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention ZIMMER FEMORAL HEAD: CATALOG #32902604935,| LOT# 07302600