FDA Adverse Event Injury Summary report: N

1020279-2013-00006

MDR report key: 2893537 · Received January 2, 2013

Report

Report Number
1020279-2013-00006
Event Type
Injury
Date Received
January 2, 2013
Date of Event
December 10, 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.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention