Brand Name | PINN POLY EXTRACTOR |
Type of Device | HIP INSTRUMENT/TRIAL |
Manufacturer (Section D) |
DEPUY ORTHOPAEDICS, INC. |
700 orthopaedic drive |
warsaw IN 46582 |
|
Manufacturer (Section G) |
DEPUY ORTHOPAEDICS, INC. |
700 orthopaedic drive |
|
warsaw IN 46582 |
|
Manufacturer Contact |
chad
gibson
|
700 orthopaedic drive |
warsaw, IN 46581
|
5743725905
|
|
MDR Report Key | 6646131 |
MDR Text Key | 77719242 |
Report Number | 1818910-2017-19600 |
Device Sequence Number | 1 |
Product Code |
HWB
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign,health pr |
Reporter Occupation |
Health Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
06/28/2017 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 06/16/2017 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | 221750001 |
Device Lot Number | J1203 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 06/28/2017 |
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 07/17/2017 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 12/15/2003 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
|
|