BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BIPOLAR

    MDR report key: 2070619 · Received April 27, 2011

    Report

    Report Number
    1020279-2011-00141
    Event Type
    Injury
    Date Received
    April 27, 2011
    Date of Event
    April 10, 2011
    Report Date
    April 27, 2011
    Manufacturer
    SMITH AND NEPHEW, INC.
    Product Code
    KWY
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BIPOLAR FEMORAL HEAD KWY SMITH AND NEPHEW, INC. 10FM19034

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Hospitalization| R