BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CMK STEM

    MDR report key: 1961940 · Received January 15, 2011

    Report

    Report Number
    8010764-2011-00002
    Event Type
    Injury
    Date Received
    January 15, 2011
    Date of Event
    June 3, 2010
    Report Date
    January 15, 2010
    Manufacturer
    SMITH & NEPHEW ORTHOPAEDICS, INC. GERMANY
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CMK STEM CMK21 STEM, 12/14 TAPER 4S1 JDH SMITH & NEPHEW ORTHOPAEDICS, INC. GERMANY 76539426 09MT37667

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R