BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SWANSON GREAT TOE IMPLANT WITH GROMMETS

    MDR report key: 506963 · Received January 16, 2004

    Report

    Report Number
    1043534-2004-00005
    Event Type
    Injury
    Date Received
    January 16, 2004
    Date of Event
    December 4, 2003
    Report Date
    December 16, 2003
    Manufacturer
    WRIGHT MEDICAL TECHNOLOGY, INC.
    Product Code
    KWD
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    RI, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    ORIG SURG. 2 YRS. AGO. ALLEGEDLY PT HAD RECENT REJECTION WITHOUT REACTIVE BONE CHANGES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SWANSON GREAT TOE IMPLANT WITH GROMMETS SMALL JOINT COMPONENT KWD WRIGHT MEDICAL TECHNOLOGY, INC. NA NI

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Required Intervention