BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER

    MDR report key: 39745 · Received March 28, 1995

    Report

    Report Number
    33141-1995-00013
    Event Type
    Injury
    Date Received
    March 28, 1995
    Date of Event
    March 23, 1995
    Report Date
    March 27, 1995
    Manufacturer
    ZIMMER
    Product Code
    HTG
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IN, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PT COMPLAINED OF PAIN. IT WAS FOUND THAT THE PLASTIC HAD SEPARATED FROM THE METAL. THE PATELLA WAS REPLACED WITH A 00-5220-012-00.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER Implant MG PATELLA HTG ZIMMER * 67652000

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Required Intervention