FDA Adverse Event Injury Summary report: N

JOURNEY I BCS

MDR report key: 3040232 · Received April 8, 2013

Report

Report Number
1020279-2013-00197
Event Type
Injury
Date Received
April 8, 2013
Date of Event
March 14, 2013
Report Date
March 14, 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 ARTICULAR INSERT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
144191 JOURNEY I BCS JOURN ART INS BCS STD 7-8 RT11 JWH SMITH & NEPHEW, INC. 07CM10615

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention (B)(4)