FDA Adverse Event Injury Summary report: N

GENESIS II

MDR report key: 1140992 · Received August 29, 2008

Report

Report Number
1020279-2008-00241
Event Type
Injury
Date Received
August 29, 2008
Date of Event
May 13, 2008
Report Date
August 29, 2008
Manufacturer
SMITH & NEPHEW, INC., ORTHOPAEDIC DIV.
Product Code
HSA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO DISLOCATION OF THE INSERT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GENESIS II INSERT HSA SMITH & NEPHEW, INC., ORTHOPAEDIC DIV. NA 07MM12223

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization| R