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 |