FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3131948 · Received May 29, 2013

Report

Report Number
3005477969-2013-00219
Event Type
Injury
Date Received
May 29, 2013
Date of Event
May 7, 2013
Report Date
February 28, 2014
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO PAIN AND ELEVATED METAL ION LEVELS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
234412 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD 53355 038

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL HEAD, PART # 74121146, LOT # 50892 154