BEUDAMED
    FDA Adverse Event Injury Summary report: N

    1020279-2014-00289

    MDR report key: 3782024 · Received April 30, 2014

    Report

    Report Number
    1020279-2014-00289
    Event Type
    Injury
    Date Received
    April 30, 2014
    Date of Event
    April 21, 2014
    Report Date
    April 30, 2014
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED FOR THE PATELLA DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    260558 JWH SMITH & NEPHEW, INC. 12JM14736

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Required Intervention 71420170/ 12KM02412| 71453221/ 12KM01623| 71421217/ 12KM15775| 71271440/ 12AC07310