Brand Name | OFFSET CUP IMPACTOR |
Type of Device | OFFSET CUP IMPACTOR |
Manufacturer (Section D) |
GREATBATCH MEDICAL SA |
l' echelette 7 |
orvin CH-25 34 |
SZ CH-2534 |
|
Manufacturer (Section G) |
GREATBATCH MEDICAL SA |
l'echelette 7 |
ch-2534 |
orvin, |
SZ
|
|
Manufacturer Contact |
noe
rivera
|
4545 kroemer road |
fort wayne, IN 46818
|
2607557490
|
|
MDR Report Key | 3908239 |
MDR Text Key | 20697297 |
Report Number | 9614497-2014-00064 |
Device Sequence Number | 1 |
Product Code |
HWA
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
User Facility,Company Representative,Distributor,company representati |
Reporter Occupation |
Not Applicable
|
Type of Report
| Initial,Followup,Followup |
Report Date |
05/14/2016 |
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 | OR71368569 |
Device Catalogue Number | T12083 |
Device Lot Number | 10LM10033 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
04/17/2014
|
Initial Date FDA Received | 06/05/2014 |
Supplement Dates Manufacturer Received | Not provided Not provided
|
Supplement Dates FDA Received | 05/06/2016 05/23/2016
|
Was Device Evaluated by Manufacturer? |
No
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|