FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 1962077 · Received January 17, 2011

Report

Report Number
3005477969-2011-00019
Event Type
Injury
Date Received
January 17, 2011
Date of Event
December 17, 2010
Report Date
April 20, 2011
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS, LTD.
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISON SURGERY WAS PERFORMED DUE TO RECURRENT DISLCOATION OF THE HIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 67588 001

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL HEAD, PART AND LOT UNKNOWN