FDA Adverse Event Injury Summary report: N

R3

MDR report key: 3811393 · Received May 15, 2014

Report

Report Number
3005477969-2014-00327
Event Type
Injury
Date Received
May 15, 2014
Date of Event
February 21, 2012
Report Date
May 14, 2014
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS LTD
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO FAILURE OF THE IMPLANTS. THE TYPE OF FAILURE WAS NOT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
291333 R3 COCR ACETABULAR LINER NXT SMITH & NEPHEW ORTHOPAEDICS LTD

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R FEMORAL STEM, PART AND LOT NUMBERS UNKNOWN| ACETABULAR SHELL, PART AND LOT NUMBERS UNKNOWN