BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JET X

    MDR report key: 546910 · Received September 30, 2004

    Report

    Report Number
    1020279-2004-00580
    Event Type
    Injury
    Date Received
    September 30, 2004
    Report Date
    September 30, 2004
    Manufacturer
    SMITH & NEPHEW, INC., ORTHOPAEDIC DIV.
    Product Code
    JDD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY WAS PERFORMED DUE TO THE DEVICE BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JET X LONG CENTRAL BODY JDD SMITH & NEPHEW, INC., ORTHOPAEDIC DIV. NA 02MM02359

    Patients

    Seq Age Sex Outcome Treatment
    1 13 YR Hospitalization| R