BEUDAMED
    FDA Adverse Event Injury Summary report: N

    1020279-2011-00367

    MDR report key: 2251993 · Received September 16, 2011

    Report

    Report Number
    1020279-2011-00367
    Event Type
    Injury
    Date Received
    September 16, 2011
    Date of Event
    September 8, 2011
    Report Date
    September 8, 2011
    Manufacturer
    SMITH & NEPHEW, INC
    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.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JDH SMITH & NEPHEW, INC

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R