Brand Name | PRODISC L TOTAL DISC REPLACEMENT |
Type of Device | PROTHESIS, INTERVERTEBRAL DISC |
Manufacturer (Section D) |
CENTINEL SPINE, LLC. |
900 airport rd, suite 3b |
west chester PA 19380 |
|
Manufacturer Contact |
jason
smith
|
900 airport rd, suite 3b |
west chester, PA 19380
|
4848878839
|
|
MDR Report Key | 10587034 |
MDR Text Key | 208552120 |
Report Number | 3007494564-2020-00032 |
Device Sequence Number | 1 |
Product Code |
MJO
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P050010 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
09/22/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 09/25/2020 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | SSX530K |
Device Catalogue Number | N/A |
Device Lot Number | 51175885 |
Date Manufacturer Received | 08/27/2020 |
Was Device Evaluated by Manufacturer? |
No
|
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 | 57 YR |
|
|