BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PROFIX CEMENTED TIBI

    MDR report key: 2822460 · Received November 7, 2012

    Report

    Report Number
    1020279-2012-00602
    Event Type
    Injury
    Date Received
    November 7, 2012
    Date of Event
    November 6, 2012
    Report Date
    November 6, 2012
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION WAS PERFORMED DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PROFIX CEMENTED TIBI PRO NON-POR TB BASE RT S3 JWH SMITH & NEPHEW, INC. 03FM05685

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention (B)(4)