FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 1830118 · Received September 10, 2010

Report

Report Number
3005477969-2010-00115
Event Type
Injury
Date Received
September 10, 2010
Date of Event
August 12, 2010
Report Date
September 10, 2010
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS, LTD.
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR RESURFACING FEMORAL HEAD NXT SMITH & NEPHEW ORTHOPAEDICS, LTD.

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R ACETABULAR CUP, EXACT PART AND LOT UNKNOWN