BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK PHK ARTICULAR SURFACE

    MDR report key: 4317094 · Received December 4, 2014

    Report

    Report Number
    1822565-2014-01691
    Event Type
    Injury
    Date Received
    December 4, 2014
    Date of Event
    October 29, 2014
    Report Date
    November 5, 2014
    Manufacturer
    ZIMMER, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    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 IS REPORTED THAT THE PT WAS REVISED DUE TO MIGRATION OF THE ARTICULAR SURFACE HINGE PIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    784644 UNK PHK ARTICULAR SURFACE KNEE PROSTHESIS JWH ZIMMER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention