FDA Adverse Event Injury Summary report: N

HIP IMPLANT

MDR report key: 3921546 · Received July 9, 2014

Report

Report Number
1020279-2014-00397
Event Type
Injury
Date Received
July 9, 2014
Date of Event
June 23, 2014
Report Date
November 18, 2014
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JDH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SUGERY WAS PERFORMED DUE TO DISLOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
401362 HIP IMPLANT JDH SMITH & NEPHEW, INC.

Patients

Seq Age Sex Outcome Treatment
1 64 YR 71303200