BEUDAMED
    FDA Adverse Event Other Summary report: N

    ZIMMER

    MDR report key: 743754 · Received June 17, 2005

    Report

    Report Number
    MW1035755
    Event Type
    Other
    Date Received
    June 17, 2005
    Date of Event
    March 29, 2005
    Report Date
    May 3, 2005
    Manufacturer
    ZIMMER US INC.
    Product Code
    JWH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE PT HAD A TKA PLACED 2.5 YEARS AGO. READMITTED FOR MALFUNCTION OF INTERNAL ORTHOPEDIC DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER NEXGEN COMPLETE KNEE SOLUTION (TIBIAL) JWH ZIMMER US INC. * 51411700

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Other