BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SMITH & NEPHEW

    MDR report key: 1192186 · Received October 2, 2008

    Report

    Report Number
    1192186
    Event Type
    Injury
    Date Received
    October 2, 2008
    Date of Event
    August 19, 2008
    Report Date
    August 28, 2008
    Manufacturer
    SMITH & NEPHEW
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    OK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WAS ADMITTED FOR REVISION OF LEFT TOTAL KNEE SECONDARY TO PAIN & INSTABILITY, SECONDARY TO LOOSE TIBIAL & FEMORAL COMPONENTS. SENDING ALL DOCUMENTATION AVAILABLE ON COMPONENTS. IN ACCORDACE WITH HOSP POLICY, THE COMPONENTS REMOVED ARE NOT AVAILABLE FOR RELEASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SMITH & NEPHEW * JWH SMITH & NEPHEW * *

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Hospitalization| R