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