Brand Name | PROFEMUR(R) MODULAR FEMORAL NECK |
Type of Device | HIP COMPONENT |
Manufacturer (Section D) |
MICROPORT ORTHOPEDICS INC. |
5677 airline rd. |
arlington TN 38002 |
|
MDR Report Key | 7451110 |
MDR Text Key | 106180495 |
Report Number | 3010536692-2018-00458 |
Device Sequence Number | 1 |
Product Code |
LWJ
|
Combination Product (y/n) | N |
PMA/PMN Number | K003016 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional |
Type of Report
| Initial,Followup,Followup |
Report Date |
02/24/2020 |
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 |
Other
|
Device Model Number | PHA0-1252 |
Device Catalogue Number | PHA0-1252 |
Device Lot Number | 1558800 |
Was Device Available for Evaluation? |
No
|
Was the Report Sent to FDA? |
No
|
Distributor Facility Aware Date | 04/13/2018 |
Initial Date Manufacturer Received |
04/13/2018
|
Initial Date FDA Received | 04/23/2018 |
Supplement Dates Manufacturer Received | 04/13/2018 04/13/2018
|
Supplement Dates FDA Received | 10/04/2019 02/24/2020
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|