FDA Adverse Event Death Summary report: N

GENESISII TIBIAL INSERT AND FEMORAL COMPONENT

MDR report key: 4089131 · Received September 15, 2014

Report

Report Number
1020279-2014-00556
Event Type
Death
Date Received
September 15, 2014
Date of Event
September 2, 2014
Report Date
September 2, 2014
Manufacturer
SMITH & NEPHEW, INC.
Product Code
HSX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED THAT THERE WAS A PATIENT DEATH. NO OTHER INFORMATION HAS BEEN PROVIDED AT THIS TIME. DETAILS OF THE CAUSE OF DEATH HAVE BEEN REQUESTED.

Additional Manufacturer Narrative · 1

CORRECTION : CHECKED BOX INDICATED FOR DEATH. PATIENT DEATH WAS PREVIOUSLY REPORTED, HOWEVER BOX WAS NOT CHECKED.

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED. THE CAUSE IS UNKNOWN AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
568468 GENESISII TIBIAL INSERT AND FEMORAL COMPONENT HSX SMITH & NEPHEW, INC.

Patients

Seq Age Sex Outcome Treatment
1 Death| R