BEUDAMED
    FDA Adverse Event Summary report: N

    1020279-2014-00416

    MDR report key: 3932688 · Received July 14, 2014

    Report

    Report Number
    1020279-2014-00416
    Date Received
    July 14, 2014
    Date of Event
    September 4, 2012
    Report Date
    August 9, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS REQUIRED. THE REASON IS UNKNOWN. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    409784 JWH SMITH & NEPHEW, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention