BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REFLECTION PRIMARY LINER

    MDR report key: 2972292 · Received February 21, 2013

    Report

    Report Number
    1020279-2013-00113
    Event Type
    Injury
    Date Received
    February 21, 2013
    Date of Event
    February 8, 2013
    Report Date
    February 8, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    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 SURGERY WAS PERFORMED DUE TO LOOSENING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    75600 REFLECTION PRIMARY LINER HIP IMPLANT JDH SMITH & NEPHEW, INC. 12GM07919

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention