FDA Adverse Event Injury Summary report: N

ECHELON

MDR report key: 1915183 · Received December 6, 2010

Report

Report Number
1020279-2010-00346
Event Type
Injury
Date Received
December 6, 2010
Report Date
December 6, 2010
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS
Product Code
JDH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO A FRACTURE OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ECHELON FEMORAL COMPONENT JDH SMITH & NEPHEW ORTHOPAEDICS

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R