FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3001543 · Received March 13, 2013

Report

Report Number
3005477969-2013-00074
Event Type
Injury
Date Received
March 13, 2013
Date of Event
March 5, 2013
Report Date
March 13, 2013
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
105536 BHR MODULAR HEAD NXT SMITH & NEPHEW ORTHOPAEDICS LTD

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R