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