FDA Adverse Event Injury Summary report: N

LEGION CR

MDR report key: 3093477 · Received May 6, 2013

Report

Report Number
1020279-2013-00249
Event Type
Injury
Date Received
May 6, 2013
Date of Event
April 30, 2013
Report Date
April 30, 2013
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SURGERY WAS REQUIRED DUE TO FEMORAL COMPONENT LOOSENING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
197431 LEGION CR LGN POROUS CR FEM SZ 8R JWH SMITH & NEPHEW, INC. 09GHA0034A

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention