Brand Name | ADVANCE(R) II COCR TIBIAL BASE |
Type of Device | KNEE COMPONENT |
Manufacturer (Section D) |
MICROPORT ORTHOPEDICS INC. |
5677 airline rd. |
arlington TN 38002 |
|
Manufacturer (Section G) |
MICROPORT ORTHOPEDICS INC. |
5677 airline rd. |
|
arlington TN 38002 |
|
Manufacturer Contact |
|
5677 airline road |
arlington, TN 38002
|
9018674771
|
|
MDR Report Key | 5414555 |
MDR Text Key | 37612289 |
Report Number | 3010536692-2016-00184 |
Device Sequence Number | 1 |
Product Code |
HRY
|
Combination Product (y/n) | N |
Reporter Country Code | UK |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
02/04/2016 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/06/2016 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Other
|
Device Catalogue Number | KTCC-NP40 |
Device Lot Number | 1568308 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Distributor Facility Aware Date | 09/08/2015 |
Event Location |
Hospital
|
Date Manufacturer Received | 01/15/2016 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 67 YR |
|
|