FDA Adverse Event Injury Summary report: N

1020279-2013-00225

MDR report key: 3073618 · Received April 23, 2013

Report

Report Number
1020279-2013-00225
Event Type
Injury
Date Received
April 23, 2013
Date of Event
April 23, 2013
Report Date
April 23, 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 PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
174839 JWH SMITH & NEPHEW, INC.

Patients

Seq Age Sex Outcome Treatment
1 41 YR Hospitalization| R