BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NKII DURASUL U/CONG TIB INS SZ 00/0, LT, 16MM

    MDR report key: 567262 · Received January 19, 2005

    Report

    Report Number
    567262
    Event Type
    Injury
    Date Received
    January 19, 2005
    Date of Event
    November 10, 2004
    Report Date
    January 19, 2005
    Manufacturer
    ZIMMER AUSTIN, INC.
    Product Code
    HSH
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PT WAS REVISED IN 2004.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NKII DURASUL U/CONG TIB INS SZ 00/0, LT, 16MM KNEE PROSTHESIS HSH ZIMMER AUSTIN, INC. NA 1479127

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Hospitalization (LOT#1542701) (2004).| 6324-00-100 NK II +4MM MOD B-PLAT CONS SZ0 LF| (LOT#1558664) (2004).| 6215-00-090 NK II REV TIB STM 90MM