FDA Adverse Event Injury Summary report: N

RESURFACING

MDR report key: 2904855 · Received January 9, 2013

Report

Report Number
1020279-2013-00020
Event Type
Injury
Date Received
January 9, 2013
Date of Event
December 4, 2012
Report Date
December 4, 2012
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION WAS PERFORMED DUE TO A BROKEN PATELLA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
11709 RESURFACING GNS II RESURF PAT 35MM JWH SMITH & NEPHEW, INC. 08KM08453

Patients

Seq Age Sex Outcome Treatment
1 68 YR Hospitalization| R