FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 1140970 · Received August 28, 2008

Report

Report Number
3005477969-2008-00063
Event Type
Injury
Date Received
August 28, 2008
Date of Event
July 1, 2008
Report Date
August 28, 2008
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD., U.K.
Product Code
KWY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR RESURFACING FEMORAL HEAD KWY SMITH & NEPHEW ORTHOPAEDICS LTD., U.K. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 38 YR Hospitalization| R PSOAS INJECTION PRIOR TO REVISION