BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JOURNEY I BCS

    MDR report key: 2964555 · Received February 15, 2013

    Report

    Report Number
    1020279-2013-00103
    Event Type
    Injury
    Date Received
    February 15, 2013
    Date of Event
    February 13, 2013
    Report Date
    February 13, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

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

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    66601 JOURNEY I BCS JOURN ART INS BCS STD 3-4 LT10 JWH SMITH & NEPHEW, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention