BEUDAMED
    FDA Adverse Event Injury Summary report: N

    FEMORAL COMPONENT

    MDR report key: 2831959 · Received November 14, 2012

    Report

    Report Number
    1020279-2012-00623
    Event Type
    Injury
    Date Received
    November 14, 2012
    Date of Event
    October 10, 2012
    Report Date
    October 29, 2012
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R