FDA Adverse Event
Injury
Summary report: N
GENESIS II
MDR report key: 1012578
·
Received March 12, 2008
Report
- Report Number
- 1020279-2008-00081
- Event Type
- Injury
- Date Received
- March 12, 2008
- Report Date
- March 12, 2008
- Manufacturer
- SMITH & NEPHEW, INC., ORTHOPAEDIC DIV.
- Product Code
- HSH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AS
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO LOOSENING OF THE TIBIAL BASE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | GENESIS II | TIBIAL BASE | HSH | SMITH & NEPHEW, INC., ORTHOPAEDIC DIV. | NA | 06JM15775 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | Hospitalization| R | LOT NUMBER: 05LT93253| PRODUCT NUMBER: 71421508, |