Brand Name | MAGEC SPINAL BRACING AND DISTRACTION SYSTEM |
Type of Device | GROWING ROD SYSTEM-MAGNETIC ACTUATION |
Manufacturer (Section D) |
NUVASIVE SPECIALIZED ORTHOPEDICS, INCORPORATED |
101 enterprise |
suite 100 |
aliso viejo CA 92656 |
|
MDR Report Key | 9951886 |
MDR Text Key | 191897016 |
Report Number | 3006179046-2020-00233 |
Device Sequence Number | 1 |
Product Code |
PGN
|
UDI-Device Identifier | 00856719002190 |
UDI-Public | 856719002190 |
Combination Product (y/n) | N |
PMA/PMN Number | K171791 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Type of Report
| Initial,Followup |
Report Date |
04/12/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 04/12/2020 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | RA002-5555SL |
Device Lot Number | A141014-17 |
Was Device Available for Evaluation? |
No
|
Was the Report Sent to FDA? |
No
|
Date Manufacturer Received | 04/12/2020 |
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 12 YR |
|
|