BEUDAMED
    FDA Adverse Event Other Summary report: N

    UNK KNEE

    MDR report key: 2170131 · Received June 22, 2011

    Report

    Report Number
    1644408-2011-00351
    Event Type
    Other
    Date Received
    June 22, 2011
    Date of Event
    June 9, 2011
    Report Date
    June 9, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UT, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - DUE TO REPLACEMENT OF THE INSERT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK KNEE PRIMARY INSERT JWH ENCORE MEDICAL, L.P. NA

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Required Intervention