BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REFLECTION

    MDR report key: 3040451 · Received April 8, 2013

    Report

    Report Number
    1020279-2013-00199
    Event Type
    Injury
    Date Received
    April 8, 2013
    Date of Event
    March 22, 2013
    Report Date
    April 4, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI
    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
    143586 REFLECTION LINER JDH SMITH & NEPHEW, INC. 04AM05208

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Hospitalization