BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COCR

    MDR report key: 2192049 · Received August 4, 2011

    Report

    Report Number
    1020279-2011-00300
    Event Type
    Injury
    Date Received
    August 4, 2011
    Date of Event
    June 10, 2011
    Report Date
    July 22, 2011
    Manufacturer
    SMITH AND NEPHEW, INC
    Product Code
    MBL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED DUE TO INFECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COCR FEMORAL HEAD COMPONENT MBL SMITH AND NEPHEW, INC

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R