FDA Adverse Event
Injury
Summary report: N
1020279-2011-00274
MDR report key: 2173112
·
Received July 23, 2011
Report
- Report Number
- 1020279-2011-00274
- Event Type
- Injury
- Date Received
- July 23, 2011
- Date of Event
- July 7, 2011
- Report Date
- July 19, 2011
- Manufacturer
- SMITH & NEPHEW, ORTHOPEDICS
- Product Code
- JDH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO A BONE FRACTURE CAUSED BY THE PATIENT FALLING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | JDH | SMITH & NEPHEW, ORTHOPEDICS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |