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 |