FDA Adverse Event Injury Summary report: N

SYNERGY

MDR report key: 2891315 · Received December 31, 2012

Report

Report Number
1020279-2012-00721
Event Type
Injury
Date Received
December 31, 2012
Date of Event
December 10, 2012
Report Date
December 14, 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 SURGERY WAS PERFORMED DUE TO A BONE FRACTURE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R