BEUDAMED
    FDA Adverse Event Injury Summary report: N

    R3

    MDR report key: 2192050 · Received August 4, 2011

    Report

    Report Number
    1020279-2011-00299
    Event Type
    Injury
    Date Received
    August 4, 2011
    Date of Event
    August 12, 2010
    Report Date
    July 12, 2011
    Manufacturer
    SMITH AND NEPHEW, INC
    Product Code
    LZO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    MEDICAL ASSISTANT

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PEFORMED DUE TO IMPLANT FAILURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 R3 ACETABULAR LINER LZO SMITH AND NEPHEW, INC

    Patients

    Seq Age Sex Outcome Treatment
    1