BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    J+J

    MDR report key: 423913 · Received October 22, 2002

    Report

    Report Number
    MW1026492
    Event Type
    Malfunction
    Date Received
    October 22, 2002
    Date of Event
    September 25, 2002
    Report Date
    October 3, 2002
    Manufacturer
    J + J
    Product Code
    KWB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CHRONIC DISLOCATION LEFT HIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 J+J ACETABULAR LINER KWB J + J UNDETERMINED UNDETERMINED
    2 HOWMEDICA HEAD KWB HOWMEDICA UNDETERMINED UNDETERMINED

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Other