BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INTERTAN 10S NAILS

    MDR report key: 3870689 · Received June 12, 2014

    Report

    Report Number
    1020279-2014-00366
    Event Type
    Injury
    Date Received
    June 12, 2014
    Date of Event
    June 4, 2014
    Report Date
    June 4, 2014
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDS
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Additional Manufacturer Narrative · 1

    .

    Description of Event or Problem · 1

    IT WAS REPORTED A REVISION SURGERY WAS PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    347919 INTERTAN 10S NAILS INTERTAN 11.5MM X 18CM 125D JDS SMITH & NEPHEW, INC. 13JM08631

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R 71677110 LAG/COM SCREW KIT 110/105 LOT 10JM06764| 71645045 TRIGEN LPS LOT 13BM08108