BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HAI MEDIC

    MDR report key: 2213787 · Received June 26, 2007

    Report

    Report Number
    MW5021734
    Event Type
    Malfunction
    Date Received
    June 26, 2007
    Date of Event
    March 30, 2007
    Report Date
    June 26, 2007
    Product Code
    JWH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    MALFUNCTION OF LEFT TKR PLACED IN 2003. EQUIPMENT REMOVED: REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HAI MEDIC LT KNEE JWH

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other