FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3142116 · Received June 3, 2013

Report

Report Number
3005477969-2013-00224
Event Type
Injury
Date Received
June 3, 2013
Date of Event
October 10, 2009
Report Date
June 3, 2013
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRIOR REVISION REFERRED TO ABOVE WAS REPORTED VIA MDR 3005477969-2013-00223. SUBSEQUENT REVISION IS TO BE REPORTED VIA MDR 3005477969-2013-00225.

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
244413 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL HEAD, PART AND LOT # UNKNOWN