FDA Adverse Event Injury Summary report: N

JOURNEY BCS

MDR report key: 1882374 · Received October 26, 2010

Report

Report Number
1020279-2010-00298
Event Type
Injury
Date Received
October 26, 2010
Report Date
October 26, 2010
Manufacturer
SMITH & NEPHEW, INC., BROOKS MANUFACTURING SITE
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED, DUE TO DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 JOURNEY BCS TIBIAL INSERT JWH SMITH & NEPHEW, INC., BROOKS MANUFACTURING SITE

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R