FDA Adverse Event Injury Summary report: N

KNEE IMPLANT

MDR report key: 2143197 · Received June 28, 2011

Report

Report Number
1020279-2011-00228
Event Type
Injury
Date Received
June 28, 2011
Date of Event
June 6, 2011
Report Date
June 28, 2011
Manufacturer
SMTIH & NEPHEW, INC. ORTHOPAEDIC DIVISION
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT HAS BEEN REPORTED THAT A REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KNEE IMPLANT INSERT JWH SMTIH & NEPHEW, INC. ORTHOPAEDIC DIVISION

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R