FDA Adverse Event
Injury
Summary report: N
UNKNOWN HIP
MDR report key: 6301080
·
Received February 3, 2017
Report
- Report Number
- 0001822565-2017-00442
- Event Type
- Injury
- Date Received
- February 3, 2017
- Report Date
- January 30, 2017
- Manufacturer
- ZIMMER, INC.
- Product Code
- JDI
- PMA / PMN Number
- PNI
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THE PRODUCT IDENTIFICATION NECESSARY TO REVIEW MANUFACTURING HISTORY WAS NOT PROVIDED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. MATTHIEU OLLIVIER, ET AL. ¿USE OF POROUS TANTALUM COMPONENTS IN PAPROSKY TWO AND THREE ACETABULAR REVISION. A MINIMUM FIVE-YEAR FOLLOW-UP OF FIFT ONE HIPS.¿ 10.1007/S00264-016-3312-2.
Description of Event or Problem · 1
IT WAS REPORTED IN A JOURNAL ARTICLE THAT 2 PATIENTS EXPERIENCED PARTIAL RADIOLUCENT LINES WITHOUT MIGRATION OF THE COMPONENT. NO REVISION PROCEDURE HAS BEEN REPORTED AND PATIENT OUTCOME IS UNKNOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 84923 | UNKNOWN HIP | PROSTHESIS, HIP | JDI | ZIMMER, INC. | N/A | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |