FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3895821 · Received June 26, 2014

Report

Report Number
3005477969-2014-00376
Event Type
Injury
Date Received
June 26, 2014
Date of Event
August 6, 2013
Report Date
June 25, 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 DEVICES. THE TYPE OF FAILURE WAS NOT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
374203 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS LTD

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R HEMI HEAD, PART AND LOT NUMBERS UNKNOWN