MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,foreign,other report with the FDA on 2020-02-12 for BHR ACETABULAR CUP 60MM 74120160 manufactured by Smith & Nephew Orthopaedics Ltd.
[178744762]
(b)(4).
Patient Sequence No: 1, Text Type: N, H10
[178744763]
It was reported that right hip revision surgery was performed due to pain, metallosis, memory loss and leg length discrepancy.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3005975929-2020-00050 |
| MDR Report Key | 9699216 |
| Report Source | CONSUMER,FOREIGN,OTHER |
| Date Received | 2020-02-12 |
| Date of Report | 2020-02-12 |
| Date of Event | 2015-04-21 |
| Date Mfgr Received | 2019-11-01 |
| Device Manufacturer Date | 2009-03-05 |
| Date Added to Maude | 2020-02-12 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | DR. SARAH FREESTONE |
| Manufacturer G1 | SMITH & NEPHEW ORTHOPAEDICS LTD |
| Manufacturer Street | AURORA HOUSE SPA PARK |
| Manufacturer City | LEAMINGTON SPA CV313HL |
| Manufacturer Country | UK |
| Manufacturer Postal Code | CV31 3HL |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BHR ACETABULAR CUP 60MM |
| Generic Name | PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING |
| Product Code | NXT |
| Date Received | 2020-02-12 |
| Catalog Number | 74120160 |
| Lot Number | 098133 |
| Device Expiration Date | 2014-02-28 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SMITH & NEPHEW ORTHOPAEDICS LTD |
| Manufacturer Address | AURORA HOUSE SPA PARK LEAMINGTON SPA CV313HL UK CV31 3HL |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2020-02-12 |