FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 2161139 · Received July 13, 2011

Report

Report Number
3005477969-2011-00147
Event Type
Injury
Date Received
July 13, 2011
Date of Event
August 19, 2009
Report Date
December 15, 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 INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 33457 093

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL HEAD PART# 121146, LOT# 35295 157