BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SMITH & NEPHEW

    MDR report key: 2153246 · Received July 1, 2011

    Report

    Report Number
    MW5021238
    Event Type
    Injury
    Date Received
    July 1, 2011
    Date of Event
    January 8, 2009
    Report Date
    June 29, 2011
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDI
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IN (B)(6) 2010, CLICKING, PAIN IN LATERAL ASPECT LEFT HIP, PAIN AT NIGHT, NO ASSISTIVE DEVICE, TROCHANTERIC BURSAL INJECTION. ON (B)(6) 2011 - PAIN CONTINUED, FOLLOW UP OFFICE VISIT, CONSERVATIVE TREATMENT FOR TROCHANTERIC BURSITIS. X-RAYS NORMAL. ON (B)(6) 2011 - SEEN IN OFFICE; RECOMMEND MRI, BLOOD WORK, PERSISTENT LEFT HIP PAIN, CLICKING, REPORTED SENSE OF GRINDING; RECOMMEND SECOND OPINION. SAME PT AS (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SMITH & NEPHEW BIRMINGHAM HIP RESURFACING IMPLANTS JDI SMITH & NEPHEW, INC. 74120148 086655
    2 ACETABULAR CUP FEMORAL HEAD BIRMINGHAM HIP RESURFACING IMPLANTS KWB SMITH & NEPHEW, INC. 74121142 077657

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Other