BEUDAMED
    FDA Adverse Event Injury Summary report: N

    1020279-2013-00007

    MDR report key: 2893533 · Received January 2, 2013

    Report

    Report Number
    1020279-2013-00007
    Event Type
    Injury
    Date Received
    January 2, 2013
    Date of Event
    December 11, 2012
    Report Date
    December 27, 2012
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION WAS PERFORMED DUE TO LAXITY OF POSTERIOR CRUCIATE LIGAMENT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION WAS PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    630 JWH SMITH & NEPHEW, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention