FDA Adverse Event Injury Summary report: N

MG II TOTAL KNEE SYSTEM TIBIAL ARTICULAR SURFACE ANTERIOR CO

MDR report key: 395043 · Received May 17, 2002

Report

Report Number
1822565-2002-00048
Event Type
Injury
Date Received
May 17, 2002
Date of Event
September 14, 2001
Report Date
April 22, 2002
Manufacturer
ZIMMER, INC.
Product Code
HRY
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT IS REPORTED THAT IN 2000 PT UNDERWENT LEFT TOTAL KNEE REPLACEMENT. FOLLOWING, ON 8/2001, WHILE GETTING OUF OF A CAR, PT TWISTED THEIR KNEE. THE NEXT MONTH, X-RAYS CONFIRMED THAT THE TIBIAL ARTICULATING SURFACE HAD DISLOCATED FROM THE TIBIAL PLATE. AS A RESULT, 4 DAYS LATER, THE KNEE WAS REVISED WHERE THE TIBIAL ARTICULATING SURFACE WAS INDEED FOUND TO BE DISPLACED. THE TIBIAL PLATE AND ARTICULATING SURFACE WERE BOTH REMOVED AND REPLACED USING MG II PRODUCTS. PT DID VERY WELL POST-OP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MG II TOTAL KNEE SYSTEM TIBIAL ARTICULAR SURFACE ANTERIOR CO KNEE PROSTHESIS HRY ZIMMER, INC. * 41263800

Patients

Seq Age Sex Outcome Treatment
1 53 YR Hospitalization| R