Catalog Number 320-10-00 |
Device Problem
Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problem
Ossification (1428)
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Event Date 08/31/2018 |
Event Type
Injury
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Manufacturer Narrative
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This event report was received through clinical data collection activities.Pending evaluation.
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Event Description
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Index surgery: (b)(6) 2018.Revision due to heterotopic ossification.The case report form indicates this event is definitely not related to devices and possibly related to procedure.
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Manufacturer Narrative
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The engineering evaluation noted that the revision reported was likely the result of heterotropic ossification.However, this cannot be confirmed as the devices were not available for evaluation and no further information was provided.
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Manufacturer Narrative
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D4: added serial number (b)(4).
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Manufacturer Narrative
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Section h10: (a1) patient identifier (in confidence): (b)(6).(b2) added check for hospitalization - initial or prolonged.(d4) expiration date: 08-may-2028, unique identifier (udi) #: (b)(4).(d5) operator of device: health_care_professional.(d6) if implanted, give date: (b)(6) 2018.(d7) if explanted, give date: (b)(6) 2018.(g5) pma/510(k)number: k063569.(h3) patient was revised on (b)(6) 2018.Only the tray, liner and glenosphere were replaced.(h4) device manufacture date: 09-may-2018.(h5) labeled for single use?: yes.Section h11: corrections made in the following section(s): (e1) initial reporter: dr.(b)(6).(e2) health professional?: yes.(e3) occupation: physician.(e4) initial reporter also sent report to fda?: no.(g1) mdr reporting contact: (b)(6).(g3) report source: health professional.
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Search Alerts/Recalls
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