MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2019-10-22 for PARTIAL TIBIAL CEMENTED SIZE D RIGHT MEDIAL N/A 42538000402 manufactured by Zimmer Orthopaedic Mfg. Ltd..
| Report Number | 3007963827-2019-00301 |
| MDR Report Key | 9217742 |
| Report Source | COMPANY REPRESENTATIVE,DISTRI |
| Date Received | 2019-10-22 |
| Date of Report | 2019-10-22 |
| Date of Event | 2019-09-27 |
| Date Mfgr Received | 2019-09-30 |
| Device Manufacturer Date | 2019-05-22 |
| Date Added to Maude | 2019-10-22 |
| 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 | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | ZIMMER ORTHOPAEDIC MFG. LTD. |
| Manufacturer Street | BUILDING NO 2 EAST PARK SHANNON INDUSTRIAL ESTATE |
| Manufacturer City | SHANNON, COUNTY CLARE |
| Manufacturer Country | EI |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PARTIAL TIBIAL CEMENTED SIZE D RIGHT MEDIAL |
| Generic Name | PROSTHESIS, KNEE |
| Product Code | HSX |
| Date Received | 2019-10-22 |
| Model Number | N/A |
| Catalog Number | 42538000402 |
| Lot Number | 64318523 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER ORTHOPAEDIC MFG. LTD. |
| Manufacturer Address | BUILDING NO 2 EAST PARK SHANNON INDUSTRIAL ESTATE SHANNON, COUNTY CLARE EI |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-10-22 |