Brand Name | MULTIPOLAR BIPOLAR CUP SHELL |
Manufacturer (Section D) |
ZIMMER |
route #1, km. 123.4, bldg. #1 |
turpeaux industrial park |
mercedita 00715 |
|
Manufacturer Contact |
kevin
escapule
|
p.o. box 708 |
warsaw, IN 46581-0708
|
8006136131
|
|
MDR Report Key | 4563494 |
MDR Text Key | 20732923 |
Report Number | 2648920-2015-00052 |
Device Sequence Number | 1 |
Product Code |
KWY
|
Combination Product (y/n) | N |
Reporter Country Code | DA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,Distributor |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
01/19/2015 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/26/2015 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 03/31/2014 |
Device Catalogue Number | 00500104300 |
Device Lot Number | 62676343 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 01/19/2015 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 04/01/2014 |
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 |
|
|