MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04,07 report with the FDA on 2015-05-26 for UNKNOWN ZIMMER HIP manufactured by Zimmer Inc.
[20362674]
It is reported that the pt is alleging harm caused by the device, however the nature of the harm is unk at this time.
Patient Sequence No: 1, Text Type: D, B5
[20688980]
Surgical notes were not provided. X-rays were not provided; it is unk whether the components were implanted with the correct fit and orientation as per the surgical technique. Pt factors that may affect the performance of the components such as age, bone quality, height/weight, type of activity (low impact vs. High impact), and relevant medical history are unk. Adherence to rehabilitation protocol is unk. Cause cannot be definitively determined. No devices or photos were received; therefore, the condition of the components is unk. Review of the device history records was not possible as the product and/or lot numbers required for retrieval were unavailable. 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 additional 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 | 1822565-2015-00765 |
| MDR Report Key | 4797717 |
| Report Source | 04,07 |
| Date Received | 2015-05-26 |
| Date of Report | 2015-04-21 |
| Date Mfgr Received | 2015-04-21 |
| Date Added to Maude | 2015-05-28 |
| 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 | P.O. 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 HIP |
| Generic Name | HIP PROSTHESIS |
| Product Code | KWB |
| Date Received | 2015-05-26 |
| 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 | P.O. BOX 708 WARSAW IN 46581070 US 46581 0708 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2015-05-26 |