FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 2240566 · Received September 9, 2011

Report

Report Number
3005477969-2011-00221
Event Type
Injury
Date Received
September 9, 2011
Date of Event
October 16, 2003
Report Date
September 9, 2011
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD

Patients

Seq Age Sex Outcome Treatment
1 63 YR Hospitalization| R FEMORAL HEAD, PART# 74121150, LOT# UNKNOWN