FDA Adverse Event Injury Summary report: N

TANDEM

MDR report key: 3433395 · Received October 28, 2013

Report

Report Number
1020279-2013-00537
Event Type
Injury
Date Received
October 28, 2013
Report Date
October 8, 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 THAT REVISION SURGERY WAS PERFORMED DUE TO PROGRESSIVE DJD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
550870 TANDEM FEMORAL COMPONENT JDH SMITH & NEPHEW, INC. 11CM00915

Patients

Seq Age Sex Outcome Treatment
1 83 YR Hospitalization| R