FDA Adverse Event Injury Summary report: N

REFLECTION

MDR report key: 3790457 · Received May 5, 2014

Report

Report Number
1020279-2014-00296
Event Type
Injury
Date Received
May 5, 2014
Date of Event
April 17, 2014
Report Date
April 17, 2014
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 REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
268600 REFLECTION FEMORAL COMPONENT JDH SMITH & NEPHEW, INC. 41004700B

Patients

Seq Age Sex Outcome Treatment
1 87 YR Hospitalization