FDA Adverse Event
Injury
Summary report: N
1020279-2014-00271
MDR report key: 3755827
·
Received April 17, 2014
Report
- Report Number
- 1020279-2014-00271
- Event Type
- Injury
- Date Received
- April 17, 2014
- Date of Event
- April 15, 2014
- Report Date
- June 17, 2014
- Manufacturer
- SMITH & NEPHEW, INC.
- Product Code
- JWH
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE CORRECT MANUFACTURING SITE SHOULD BE 8010765.
Additional Manufacturer Narrative · 1
.
Description of Event or Problem · 1
IT WAS REPORTED THAT A REVISION WAS PERFORMED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 234278 | JWH | SMITH & NEPHEW, INC. | 09GT33851 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 66 YR | Hospitalization| R |