FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3172166 · Received June 17, 2013

Report

Report Number
3005477969-2013-00246
Event Type
Injury
Date Received
June 17, 2013
Date of Event
May 25, 2011
Report Date
September 20, 2013
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO HIP AND LEG PAIN, WHICH BEGAN IN 2010.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
272798 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD 083242

Patients

Seq Age Sex Outcome Treatment
1 60 YR Hospitalization| R FEMORAL HEAD, # 74121146, LOT # 07KW14081