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..
[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
Report Number | 1822565-2012-02024 |
MDR Report Key | 2783656 |
Report Source | 04,07 |
Date Received | 2012-10-04 |
Date of Report | 2012-09-05 |
Date Mfgr Received | 2012-09-05 |
Date Added to Maude | 2012-10-12 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 0 |
Event Location | 0 |
Manufacturer Contact | KEVIN ESCAPULE |
Manufacturer Street | PO BOX 708 |
Manufacturer City | WARSAW IN 465810708 |
Manufacturer Country | US |
Manufacturer Postal | 465810708 |
Manufacturer Phone | 8006136131 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | UNKNOWN ZIMMER KNEE IMPLANT |
Generic Name | KNEE PROSTHESIS |
Product Code | HRZ |
Date Received | 2012-10-04 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | DA |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ZIMMER, INC. |
Manufacturer Address | PO BOX 708 WARSAW IN 46581070 US 46581 0708 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2012-10-04 |