Brand Name | ATTUNE SHIM SZ5 5MM |
Type of Device | SHIM |
Manufacturer (Section D) |
DEPUY IRELAND 9616671 |
loughbeg, ringaskiddy co. |
cork |
EI |
|
Manufacturer (Section G) |
DEPUY ORTHOPAEDICS, INC. 1818910 |
700 orthopaedic dr. |
|
warsaw IN 46582 |
|
Manufacturer Contact |
chad
gibson
|
700 orthopaedic dr. |
warsaw, IN 46582
|
5743725905
|
|
MDR Report Key | 7103917 |
MDR Text Key | 94409746 |
Report Number | 1818910-2017-51151 |
Device Sequence Number | 1 |
Product Code |
HWT
|
UDI-Device Identifier | 10603295133438 |
UDI-Public | 10603295133438 |
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,user f |
Reporter Occupation |
Health Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
11/14/2017 |
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 | 254500651 |
Device Lot Number | MVMBLC860 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 01/15/2018 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
11/14/2017
|
Initial Date FDA Received | 12/11/2017 |
Supplement Dates Manufacturer Received | 01/15/2018 01/18/2018
|
Supplement Dates FDA Received | 01/19/2018 01/24/2018
|
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 06/27/2013 |
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 |
|
|