FDA Adverse Event Injury Summary report: N

1020279-2012-00182

MDR report key: 2499036 · Received March 21, 2012

Report

Report Number
1020279-2012-00182
Event Type
Injury
Date Received
March 21, 2012
Date of Event
January 1, 1901
Report Date
March 2, 2012
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 WAS PERFORMED DUE TO PAIN.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization