BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GII

    MDR report key: 3932992 · Received July 14, 2014

    Report

    Report Number
    1020279-2014-00421
    Event Type
    Injury
    Date Received
    July 14, 2014
    Date of Event
    June 19, 2014
    Report Date
    July 3, 2014
    Manufacturer
    SMITH&NEPHEW, INC
    Product Code
    JWH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PEFORMED. THE CAUSE OF THE REVISION IS UNKNOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    410682 GII FEMORAL COMPONENT JWH SMITH&NEPHEW, INC

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R