BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ZIMMER

    MDR report key: 988804 · Received January 22, 2008

    Report

    Report Number
    988804
    Event Type
    Malfunction
    Date Received
    January 22, 2008
    Date of Event
    November 19, 2007
    Report Date
    January 22, 2008
    Manufacturer
    ZIMMER USA INC.
    Product Code
    HXX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT HAVING LEFT TOTAL HIP ARTHROPLASTY. TIP OF ZIMMER SCREWDRIVER BROKE OFF IN ACE-TABULAR CUP. REPRESENTATIVE FOR ZIMMER COMPANY IN ROOM AND TOOK SCREWDRIVER BACK TO COMPANY WITH HIM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZIMMER SCREWDRIVER HXX ZIMMER USA INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 YR Other