NATURAL KNEE II CONSTRAINED KNEE SYSTEM 6720-19-101

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2012-11-24 for NATURAL KNEE II CONSTRAINED KNEE SYSTEM 6720-19-101 manufactured by Zimmer Us Dba Center Pulse Orthopedic.

Event Text Entries

[2961969] On (b)(6) 2012, while seated at my desk at work and moving from side to side in my rolling chair, my left tkr revision became "frozen" with my left leg in a bent position. I had severe pain and could not walk. Before the lot number: 1639631 was implanted, the doctor tried and removed the same catalog number piece as a lot number 1642665. Not sure if there was a defect or a fit problem.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5027914
MDR Report Key2857733
Date Received2012-11-24
Date of Report2012-11-24
Date of Event2012-09-04
Date Added to Maude2012-12-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameNATURAL KNEE II CONSTRAINED KNEE SYSTEM
Generic NameTOTAL KNEE REPLACEMENT PLASTIC INSERT
Product CodeMBD
Date Received2012-11-24
Model NumberNATURAL KNEE II
Catalog Number6720-19-101
Lot Number1639631
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerZIMMER US DBA CENTER PULSE ORTHOPEDIC
Manufacturer AddressPO BOX 708 1800 W CENTER ST WARSAW


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2012-11-24

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