BEUDAMED
    FDA Adverse Event Injury Summary report: N

    R3 PRIMARY 46MM ID US COCR LNR 58MM

    MDR report key: 3943517 · Received July 18, 2014

    Report

    Report Number
    1020279-2014-00431
    Event Type
    Injury
    Date Received
    July 18, 2014
    Date of Event
    July 11, 2014
    Report Date
    July 18, 2014
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Additional Manufacturer Narrative · 1

    THIS MDR WAS SUBMITTED IN ERROR. IT IS A DUPLICATE WITH MDR 3005477969-2014-00401.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    422822 R3 PRIMARY 46MM ID US COCR LNR 58MM HIP IMPLANT JDH SMITH & NEPHEW, INC. 08MW20442

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention