BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNIVERSAL

    MDR report key: 2121313 · Received June 13, 2011

    Report

    Report Number
    1020279-2011-00197
    Event Type
    Injury
    Date Received
    June 13, 2011
    Date of Event
    May 25, 2011
    Report Date
    June 13, 2011
    Manufacturer
    SMITH & NEPHEW, ORTHOPEDICS
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO LOOSENING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNIVERSAL FEMORAL HEAD JDH SMITH & NEPHEW, ORTHOPEDICS

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention