Brand Name | CD HORIZON SPINAL SYSTEM |
Type of Device | APPLIANCE, FIXATION, SPINAL INTERLAMINAL |
Manufacturer (Section D) |
WARSAW ORTHOPEDICS |
2500 silveus crossing |
warsaw IN 46582 |
|
Manufacturer (Section G) |
MEDTRONIC SOFAMOR DANEK |
1800 pyramid place |
|
memphis TN 38132 |
|
Manufacturer Contact |
huzefa
mamoola
|
1800 pyramid place |
memphis, TN 38132
|
9013963133
|
|
MDR Report Key | 3757397 |
MDR Text Key | 16683087 |
Report Number | 1030489-2014-02224 |
Device Sequence Number | 1 |
Product Code |
KWP
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K090390 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
03/20/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 04/17/2014 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | 778216555 |
Device Lot Number | 0165712W |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 03/20/2014 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 06/30/2011 |
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 |
Treatment | ROD |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 00058 YR |
Patient Weight | 99 |
|
|