Brand Name | LCS COMP MOD REV FEM CEM R STD |
Type of Device | KNEE FEMORAL COMPONENT |
Manufacturer (Section D) |
DEPUY INTL., LTD.8010379 |
st. anthony's rd |
leeds, leeds LS11 8 D |
UK LS11 8 DT |
|
Manufacturer (Section G) |
DEPUY INTL., LTD.8010379 |
st. anthony's rd |
|
leeds, leeds LS11 8 D |
UK
LS11 8 DT
|
|
Manufacturer Contact |
stacey
trick
|
700 orthopaedic drive |
warsaw, IN 46581
|
5743714554
|
|
MDR Report Key | 3663298 |
MDR Text Key | 4344747 |
Report Number | 1818910-2014-13647 |
Device Sequence Number | 1 |
Product Code |
HRY
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | PP830055 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,Distributor |
Reporter Occupation |
Physician
|
Type of Report
| Initial,Followup |
Report Date |
02/13/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/06/2014 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Catalogue Number | 129441040 |
Device Lot Number | 2568755 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 03/10/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 03/30/2008 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 65 YR |
|
|