FDA Adverse Event Injury Summary report: N

NEXGEN COMPLETE KNEE SOLUTION ROTATING HINGE KNEE TIBIAL COMPONENT

MDR report key: 865914 · Received June 13, 2007

Report

Report Number
1822565-2007-00181
Event Type
Injury
Date Received
June 13, 2007
Date of Event
May 7, 2007
Report Date
May 14, 2007
Manufacturer
ZIMMER, INC.
Product Code
HRZ
Removal / Correction Number
NA
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 TIBIAL PLATE WAS IMPLANTED IN 2006. THE DEVICE WAS REVISED IN 2007, DUE TO LOOSENING. DURING REVISION SURGERY, THE SCREWDRIVER BROKE, PROLONGING SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN COMPLETE KNEE SOLUTION ROTATING HINGE KNEE TIBIAL COMPONENT KNEE PROSTHESIS HRZ ZIMMER, INC. NA 60267670

Patients

Seq Age Sex Outcome Treatment
1 YR Hospitalization| R CATALOG #00588102600 NEXGEN COMPLETE KNEE SOLUTION| ROTATING HINGE KNEE SCREW DRIVER