BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BHR

    MDR report key: 2161138 · Received July 13, 2011

    Report

    Report Number
    3005477969-2011-00148
    Event Type
    Injury
    Date Received
    July 13, 2011
    Date of Event
    March 10, 2010
    Report Date
    January 16, 2011
    Manufacturer
    SMITH & NEPHEW ORTHOPAEDICS, LTD.
    Product Code
    NXT
    PMA / PMN Number
    P040033
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FI
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO PAIN, CLACKING SOUNDS IN HIP AND SOFT TISSUE REACTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 52256 047

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R FEMORAL HEAD, PART# 74121146, LOT# --141 (PARTIAL)