BEUDAMED
    FDA Adverse Event Injury Summary report: N

    REFLECTION

    MDR report key: 3103120 · Received May 9, 2013

    Report

    Report Number
    1020279-2013-00252
    Event Type
    Injury
    Date Received
    May 9, 2013
    Date of Event
    May 6, 2013
    Report Date
    May 6, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED REVISION SURGERY WAS PERFORMED DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    203016 REFLECTION FEMORAL COMPONENT JDH SMITH & NEPHEW, INC. 02JM02094

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R