UNKNOWN ZIMMER KNEE IMPLANT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04,07 report with the FDA on 2012-10-04 for UNKNOWN ZIMMER KNEE IMPLANT manufactured by Zimmer, Inc..

Event Text Entries

[2917337] It was reported that the pt had right knee arthroplasty performed in 2008, and began experiencing pain four months later.
Patient Sequence No: 1, Text Type: D, B5


[10274072] Eval summary: no devices or photos were received; therefore the condition of the component is unk. Neither surgical notes nor x-rays were provided, therefore fit and orientation could not be evaluated. Patient factors that may affect the performance of the components such as bone quality, activity level or type of activity (low impact vs. High impact) are unk. A definitive root cause cannot be determined with the info provided. Eval - review of the device history records was not possible as the product and/or lot numbers required for retrieval were unavailable. It is not suspected that the product failed to meet specifications. The investigation could not verify or identify any evidence of product contribution to the reported problem. Based on the available info, the need for corrective action is not indicated. Should add? L substantive info be received, the complaint will be reopened. Zimmer, inc. Considers the investigation closed.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1822565-2012-02024
MDR Report Key2783656
Report Source04,07
Date Received2012-10-04
Date of Report2012-09-05
Date Mfgr Received2012-09-05
Date Added to Maude2012-10-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactKEVIN ESCAPULE
Manufacturer StreetPO BOX 708
Manufacturer CityWARSAW IN 465810708
Manufacturer CountryUS
Manufacturer Postal465810708
Manufacturer Phone8006136131
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN ZIMMER KNEE IMPLANT
Generic NameKNEE PROSTHESIS
Product CodeHRZ
Date Received2012-10-04
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER, INC.
Manufacturer AddressPO BOX 708 WARSAW IN 46581070 US 46581 0708


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2012-10-04

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