BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ZIMMER

    MDR report key: 60770 · Received December 20, 1996

    Report

    Report Number
    60770
    Event Type
    Injury
    Date Received
    December 20, 1996
    Date of Event
    November 13, 1996
    Report Date
    November 13, 1996
    Manufacturer
    ZIMMER
    Product Code
    KWB
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TOTAL HIP DONE 10/2/96 PT HAS HAD 2 DISLOCATIONS SINCE THE MIDDLE PART OF OCTOBER. REPLACED TOTAL HIP TODAY. ORIGINAL DIAGNOSIS: OSTEOARTHRITIS.ADD'L MODEL NO: 9026-28-35.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER Implant TOTAL JOINT KWB ZIMMER 6200-56-20,6120-56-28, 1299700

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Hospitalization C/N6250-65-25 S/N71363700| TOTAL HIP.| C/N 9026-28-35 S/N 13317100, 11/13/96 REVISION RT| C/N 6250-65-35 S/N 13005900| C/N 6200-60-20, L/N 13241100| C/N 6120-60-28 L/N 63049300