BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REFLECTION

    MDR report key: 2424934 · Received January 23, 2012

    Report

    Report Number
    1020279-2012-00027
    Event Type
    Injury
    Date Received
    January 23, 2012
    Date of Event
    January 3, 2012
    Report Date
    January 3, 2012
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED REVISION SURGERY WAS PERFORMED DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 REFLECTION LINER JDH SMITH & NEPHEW, INC. 51206001

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Hospitalization| R