Brand Name | V40(TM). FEMORAL HEAD 28MM Ø (V40 TAPER) LONG NECK |
Type of Device | PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROU |
Manufacturer (Section D) |
STRYKER ORTHOPAEDICS-MAHWAH |
325 corporate drive |
mahwah NJ 07430 |
|
Manufacturer (Section G) |
STRYKER ORTHOPAEDICS-CORK |
ida industrial estate |
|
carrigtwohill NA |
|
Manufacturer Contact |
sharon
rivas
|
325 corporate drive |
mahwah, NJ 07430
|
2018315000
|
|
MDR Report Key | 8204038 |
MDR Text Key | 131646763 |
Report Number | 0002249697-2018-04164 |
Device Sequence Number | 1 |
Product Code |
LZO
|
Combination Product (y/n) | N |
Reporter Country Code | FR |
PMA/PMN Number | K972361 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,other |
Reporter Occupation |
Pharmacist
|
Type of Report
| Initial |
Report Date |
12/28/2018 |
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 Catalogue Number | 63644228 |
Device Lot Number | G0003956 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
11/30/2018
|
Initial Date FDA Received | 12/28/2018 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
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 |
Patient Outcome(s) |
Hospitalization;
Required Intervention;
|
Patient Age | 73 YR |
Patient Weight | 92 |