BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GII

    MDR report key: 4203150 · Received October 27, 2014

    Report

    Report Number
    1020279-2014-00669
    Event Type
    Injury
    Date Received
    October 27, 2014
    Date of Event
    September 30, 2014
    Report Date
    October 10, 2014
    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 REVISION WAS PERFORMED DUE TO DISASSOCIATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    683277 GII FEMORAL COMPONENT JWH SMITH & NEPHEW, INC. OR71421501 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R