FDA Adverse Event Injury Summary report: N

NEXGEN CR-FLEX GSF FEMORAL COMPONENT

MDR report key: 3962602 · Received July 15, 2014

Report

Report Number
1822565-2014-00857
Event Type
Injury
Date Received
July 15, 2014
Report Date
June 16, 2014
Manufacturer
ZIMMER INC
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED FROM A CONSUMER WHO IS NOT REQUIRED TO COMPLETE FORM 3500A. THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PATIENT HAS BEEN REVISED DUE TO PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
412768 NEXGEN CR-FLEX GSF FEMORAL COMPONENT JWH ZIMMER INC 60736026

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention