FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 2252800 · Received September 19, 2011

Report

Report Number
3005477969-2011-00234
Event Type
Injury
Date Received
September 19, 2011
Date of Event
September 19, 2011
Report Date
February 21, 2012
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS, LTD.
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO FEMORAL COMPONENT LOOSENING AND PATIENT PAIN.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SURGERY IS TO BE PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 94389 027

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL HEAD, PART & LOT# UNKNOWN| FEMORAL HEAD, PART# 74121150, LOT# 08KW19805 041