Brand Name | CLAMP, SPINOUS PROCESS SHORT |
Type of Device | ORTHOPEDIC STEREOTAXIC INSTRUMENT |
Manufacturer (Section D) |
MEDTRONIC NAVIGATION, INC. (LOUISVILLE) |
826 coal creek circle |
louisville CO 80027 |
|
Manufacturer (Section G) |
MEDTRONIC NAVIGATION, INC. (LOUISVILLE) |
826 coal creek circle |
|
louisville CO 80027 |
|
Manufacturer Contact |
heather
davis
|
attn:product quality experienc |
826 coal creek circle |
louisville, CO 80027-9710
|
7635267745
|
|
MDR Report Key | 7299064 |
MDR Text Key | 101166445 |
Report Number | 1723170-2018-00891 |
Device Sequence Number | 1 |
Product Code |
OLO
|
UDI-Device Identifier | 00643169936294 |
UDI-Public | 00643169936294 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K131425 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Reporter Occupation |
Medical Equipment Company Technician/Representative
|
Type of Report
| Initial,Followup |
Report Date |
05/27/2014,03/09/2018 |
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 |
Physician
|
Device Catalogue Number | 9734716 |
Device Lot Number | 170905 |
Is the Reporter a Health Professional? |
No
|
Date Report to Manufacturer | 05/27/2014 |
Initial Date Manufacturer Received |
01/31/2018
|
Initial Date FDA Received | 02/27/2018 |
Supplement Dates Manufacturer Received | 02/26/2018
|
Supplement Dates FDA Received | 03/09/2018
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
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 Age | 79 YR |