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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MICROPORT ORTHOPEDICS INC. CONSERVE HIP; HIP COMPONENT

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MICROPORT ORTHOPEDICS INC. CONSERVE HIP; HIP COMPONENT Back to Search Results
Device Problem Insufficient Information (3190)
Patient Problem Reaction (2414)
Event Date 01/04/2012
Event Type  Injury  
Event Description
Allegedly this patient was revised due to a periprosthetic proximal femur fracture in (b)(6) 2009.In (b)(6) 2012 he began suffering low back pain with irradiation down his left leg.He was also feeling a clicking as well as a clunk in his thr and he felt that this was contributing to his increased limp.After some examinations it was decided to undergo to a second revision surgery due to pain, pseudo instability, bearing wear tha.(left).
 
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Brand Name
CONSERVE HIP
Type of Device
HIP 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 Key6477528
MDR Text Key72293280
Report Number3010536692-2017-00278
Device Sequence Number1
Product Code HWA
Combination Product (y/n)N
Reporter Country CodeCA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other
Reporter Occupation Other
Type of Report Initial
Report Date 02/17/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/10/2017
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Physician
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Distributor Facility Aware Date01/18/2017
Date Manufacturer Received01/18/2017
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Type of Device Usage N
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age57 YR
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