BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BHR

    MDR report key: 864438 · Received June 13, 2007

    Report

    Report Number
    1020279-2007-00138
    Event Type
    Injury
    Date Received
    June 13, 2007
    Date of Event
    March 26, 2007
    Report Date
    May 15, 2007
    Manufacturer
    SMITH & NEPHEW, INC., ORTHOPAEDIC DIV
    Product Code
    JDD
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    NA

    Description of Event or Problem · 1

    IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED DUE TO PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BHR FEMORAL CUP JDD SMITH & NEPHEW, INC., ORTHOPAEDIC DIV NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 26 YR Hospitalization| R