Brand Name | ANKLE LOCKING NAIL 11 X 150MM |
Type of Device | ROD, FIXATION, INTRAMEDULLARY |
Manufacturer (Section D) |
BIOMET ORTHOPEDICS |
56 e. bell drive |
warsaw IN 46582 |
|
Manufacturer (Section G) |
BIOMET ORTHOPEDICS |
56 e. bell drive |
|
warsaw IN 46582 |
|
Manufacturer Contact |
amanda
zajicek
|
56 e. bell drive |
warsaw, IN 46582
|
5743726782
|
|
MDR Report Key | 3800104 |
MDR Text Key | 4522375 |
Report Number | 0001825034-2014-03715 |
Device Sequence Number | 1 |
Product Code |
HSB
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | PK091976 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial,Followup,Followup |
Report Date |
07/23/2014 |
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 |
Physician
|
Device Expiration Date | 03/31/2021 |
Device Model Number | N/A |
Device Catalogue Number | 14-440215 |
Device Lot Number | 147390 |
Other Device ID Number | N/A |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 05/08/2014 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
07/23/2014
|
Initial Date FDA Received | 05/08/2014 |
Supplement Dates Manufacturer Received | Not provided Not provided
|
Supplement Dates FDA Received | 06/20/2014 07/24/2014
|
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 04/08/2011 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Removal/Correction Number | N/A |
Patient Sequence Number | 1 |
Patient Outcome(s) |
Hospitalization;
Required Intervention;
|