FDA Adverse Event Injury Summary report: N

HIP IMPLANT

MDR report key: 4120881 · Received September 26, 2014

Report

Report Number
1020279-2014-00591
Event Type
Injury
Date Received
September 26, 2014
Date of Event
August 19, 2014
Report Date
August 19, 2014
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JDH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED DUE TO CRACKED LINER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
601890 HIP IMPLANT JDH SMITH & NEPHEW, INC.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention