FDA Adverse Event Injury Summary report: N

SMART SET MV - BONE CEMENT

MDR report key: 2574892 · Received April 9, 2012

Report

Report Number
MW5025360
Event Type
Injury
Date Received
April 9, 2012
Date of Event
October 29, 2009
Manufacturer
DEPUY
Product Code
LOD
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
IL, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Description of Event or Problem · 1

ON (B)(6) 2009, BILATERAL TOTAL KNEE ARTHROPLASTY FOR DJD OF BOTH KNEES. ON (B)(6) 2011, REVISION OF TIBIAL COMPONENT, RIGHT KNEE DUE TO LOOSE TIBIAL COMPONENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMART SET MV - BONE CEMENT BONE CEMENT LOD DEPUY 2946615

Patients

Seq Age Sex Outcome Treatment
1 59 YR Required Intervention