BEUDAMED
    FDA Adverse Event Injury Summary report: N

    R3 PRIMARY LINERS XL CONST 66-70MM

    MDR report key: 3932238 · Received July 14, 2014

    Report

    Report Number
    1020279-2014-00413
    Event Type
    Injury
    Date Received
    July 14, 2014
    Date of Event
    May 22, 2014
    Report Date
    November 19, 2014
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Additional Manufacturer Narrative · 1

    LOT NUMBER CORRECTED - PRODUCTS RECEIVED.

    Description of Event or Problem · 1

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

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    410396 R3 PRIMARY LINERS XL CONST 66-70MM HIP IMPLANT JDH SMITH & NEPHEW, INC. 10CM00631R

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention 71338742/11AM11216