Brand Name | TRIATHLON PRIM TIB BASEPLATE - CEMENTED |
Type of Device | PROSTHESIS, KNEE, PATELLO/FEMOROTIBIAL, SEMI-CONSTRAINED, UNCEMENTED, POROUS, CO |
Manufacturer (Section D) |
STRYKER ORTHOPAEDICS-MAHWAH |
325 corporate drive |
mahwah NJ 07430 |
|
Manufacturer (Section G) |
STRYKER ORTHOPAEDICS-MAHWAH |
325 corporate drive |
|
mahwah NJ 07430 |
|
Manufacturer Contact |
joann
ripoli
|
325 corporate drive |
mahwah, NJ 07430
|
2018315000
|
|
MDR Report Key | 16384140 |
MDR Text Key | 309636285 |
Report Number | 0002249697-2023-00164 |
Device Sequence Number | 1 |
Product Code |
MBH
|
UDI-Device Identifier | 07613327050318 |
UDI-Public | 07613327050318 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K141056 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Other,Health Professional |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
02/16/2023 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/16/2023 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | 5520-B-300 |
Device Catalogue Number | 5520-B-300 |
Device Lot Number | HR97GB |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 01/25/2023 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 10/01/2021 |
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) |
Hospitalization;
Required Intervention;
|
Patient Age | 66 |
Patient Sex | Female |