BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LGN CR HIGH FLEX XLPE SZ 3-4 9MM

    MDR report key: 2892797 · Received January 2, 2013

    Report

    Report Number
    1020279-2013-00002
    Event Type
    Injury
    Date Received
    January 2, 2013
    Date of Event
    December 17, 2012
    Report Date
    December 17, 2012
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SZ
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

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

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1306 LGN CR HIGH FLEX XLPE SZ 3-4 9MM LGN CR HIGH FLEX XLPE SZ 3-4 9MM JWH SMITH & NEPHEW, INC. 10KM20494

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Hospitalization| R