FDA Adverse Event
Injury
Summary report: N
GII OVAL RESURFACING PAT 32MM
MDR report key: 7060644
·
Received November 27, 2017
Report
- Report Number
- 1020279-2017-01127
- Event Type
- Injury
- Date Received
- November 27, 2017
- Date of Event
- April 24, 2015
- Report Date
- February 22, 2018
- Manufacturer
- SMITH & NEPHEW, INC.
- Product Code
- JWH
- UDI-DI
- 03596010485069
- PMA / PMN Number
- K951987
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- BE
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
REMAINING COMPONENTS OF THE TOTAL KNEE INVOLVED IN THIS EVENT HAVE BEEN COMMUNICATED THROUGH MDRS 1020279-2017-01125, 1020279-2017-01126 AND 1020279-2017-00985 . (B)(4).
Description of Event or Problem · 1
IT WAS REPORTED THAT AN INFILTRATION WITH DEPO-MEDROL WAS PERFORMED DUE TO HYDROPS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 839143 | GII OVAL RESURFACING PAT 32MM | PRSTHSS,KNEE,PTLLFMRTBAL,SMICNSTRIND,CMNTD,PLYMRMETALPLYMR | JWH | SMITH & NEPHEW, INC. | 13AM07279 | 03596010485069 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |