UNKNOWN ZIMMER SHOULDER GLENOID

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2015-09-15 for UNKNOWN ZIMMER SHOULDER GLENOID manufactured by Zimmer Inc.

MAUDE Entry Details

Report Number1822565-2015-01925
MDR Report Key5079115
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2015-09-15
Date of Report2015-08-20
Date Mfgr Received2015-08-20
Date Added to Maude2015-09-15
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 FDA3
Event Location3
Manufacturer ContactKEVIN ESCAPULE
Manufacturer StreetP.O. 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 SHOULDER GLENOID
Generic NameSHOULDER PROSTHESIS
Product CodeKWR
Date Received2015-09-15
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER INC
Manufacturer AddressP.O. BOX 708 WARSAW IN 465810708 US 465810708


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2015-09-15

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