Brand Name | MULTIPOLAR BIPOLAR SHELL |
Manufacturer (Section D) |
ZIMMER |
route 1, km. 123.4, bldg. 1 |
turpeaux industrial park |
mercedita PR 00715 026 |
|
Manufacturer (Section G) |
ZIMMER |
route 1, km. 123.4, bldg. 1 |
turpeaux industrial park |
mercedita PR 00715 026 |
|
Manufacturer Contact |
kevin
escapule
|
po box 708 |
warsaw, IN 46581-0708
|
8006136131
|
|
MDR Report Key | 3784885 |
MDR Text Key | 17265449 |
Report Number | 2648920-2014-00021 |
Device Sequence Number | 1 |
Product Code |
KWY
|
Combination Product (y/n) | N |
Reporter Country Code | TW |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,Distributor |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
01/10/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 05/31/2023 |
Device Catalogue Number | 00500104900 |
Device Lot Number | 62383081 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
01/10/2014 |
Initial Date FDA Received | 02/07/2014 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 06/01/2013 |
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 |
|
|