Brand Name | CD HORIZON SOLERA SPINAL SYSTEM |
Type of Device | ORTHOSIS, SPINAL PEDICLE FIXATION, FOR DEGENERATIVE DISC DISEASE |
Manufacturer (Section D) |
MDT SOFAMOR DANEK PUERTO RICO MFG |
barrio marianna rd 909, km0.4 |
humacao PR 00792 |
|
Manufacturer (Section G) |
MDT SOFAMOR DANEK PUERTO RICO MFG |
barrio marianna rd 909, km0.4 |
|
humacao PR 00792 |
|
Manufacturer Contact |
tricha
miles
|
1800 pyramid place |
memphis, TN 38132
|
7635140379
|
|
MDR Report Key | 10231466 |
MDR Text Key | 197588567 |
Report Number | 1030489-2020-00818 |
Device Sequence Number | 1 |
Product Code |
NKB
|
UDI-Device Identifier | 20643169885831 |
UDI-Public | 20643169885831 |
Combination Product (y/n) | N |
Reporter Country Code | JA |
PMA/PMN Number | K170679 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
07/06/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | 6534530 |
Device Lot Number | H5598880 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
06/11/2020
|
Initial Date FDA Received | 07/06/2020 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 02/25/2020 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|