Brand Name | ATTUNE MEDIAL DOME PAT 41MM |
Type of Device | ATTUNE IMPLANT : KNEE PATELLA |
Manufacturer (Section D) |
DEPUY IRELAND - 9616671 |
loughbeg ringaskiddy co. |
cork |
EI |
|
Manufacturer (Section G) |
DEPUY IRELAND 9616671 |
loughbeg, ringaskiddy co. |
|
cork |
EI
|
|
Manufacturer Contact |
kara
ditty-bovard
|
700 orthopaedic dr. |
warsaw, IN 46581-0988
|
6107428552
|
|
MDR Report Key | 13366589 |
MDR Text Key | 284522016 |
Report Number | 1818910-2022-01763 |
Device Sequence Number | 1 |
Product Code |
NJL
|
UDI-Device Identifier | 10603295056706 |
UDI-Public | 10603295056706 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P830055 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Study,Health Professional |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
01/27/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | 1518-20-041 |
Device Catalogue Number | 151820041 |
Device Lot Number | 9622755 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
01/18/2022 |
Initial Date FDA Received | 01/27/2022 |
Supplement Dates Manufacturer Received | 03/03/2022
|
Supplement Dates FDA Received | 03/04/2022
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 10/23/2020 |
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 | ATTUNE CR RP INSRT SZ 6 6MM; ATTUNE FEM POR CR RT SZ 6; ATTUNE MEDIAL DOME PAT 41MM; ATTUNE RP TIB BASE SZ 5 POR; DEPUY CMW 2 20G |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 69 YR |
Patient Sex | Male |
Patient Weight | 68 KG |