FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3013211 · Received March 20, 2013

Report

Report Number
3005477969-2013-00098
Event Type
Injury
Date Received
March 20, 2013
Date of Event
July 10, 2012
Report Date
March 20, 2013
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED. THE DEVICES WERE IMPLANTED IN 2006.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
116090 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD 60167 144

Patients

Seq Age Sex Outcome Treatment
1 64 YR Hospitalization| R FEMORAL HEAD, PART# 121146, LOT# 8141 012