BEUDAMED
    FDA Adverse Event Injury Summary report: N

    1020279-2011-00102

    MDR report key: 2032408 · Received March 29, 2011

    Report

    Report Number
    1020279-2011-00102
    Event Type
    Injury
    Date Received
    March 29, 2011
    Date of Event
    September 13, 2010
    Report Date
    March 29, 2011
    Manufacturer
    SMITH & NEPHEW, INC
    Product Code
    JWH
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATELLA LOOSENED REQUIRING A REVISION SURGERY TO CORRECT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JWH SMITH & NEPHEW, INC

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention