FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3022520 · Received March 27, 2013

Report

Report Number
3005477969-2013-00122
Event Type
Injury
Date Received
March 27, 2013
Date of Event
May 14, 2012
Report Date
March 27, 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 DUE TO PAIN. PAIN REPORTED SINCE THE DEVICES WERE IMPLANTED IN 2004.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
125737 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD 36380 021

Patients

Seq Age Sex Outcome Treatment
1 63 YR Hospitalization| R FEMORAL HEAD, PART AND LOT# UNKNOWN