FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 2031595 · Received March 28, 2011

Report

Report Number
3005477969-2011-00076
Event Type
Injury
Date Received
March 28, 2011
Date of Event
March 11, 2011
Report Date
June 27, 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
NURSE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT BHR REVISION SURGERY WAS PERFORMED DUE TO METAL REACTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 32547 017

Patients

Seq Age Sex Outcome Treatment
1 57 YR Hospitalization| R FEMORAL HEAD, PART#74121138, LOT#OBSCURRED BY BONE