Brand Name | PRECICE PLATING SYSTEM |
Type of Device | APPLIANCE, FIXATION, NAIL/BLADE/PLATE COMBINATION, MULTIPLE COMPONENT |
Manufacturer (Section D) |
NUVASIVE SPECIALIZED ORTHOPEDICS, INC. |
101 enterprise dr, suite 100 |
aliso viejo CA 92656 |
|
Manufacturer (Section G) |
NUVASIVE SPECIALIZED ORTHOPEDICS, INC. |
101 enterprise dr, suite 100 |
|
aliso viejo CA 92656 |
|
Manufacturer Contact |
tiara
rae
|
101 enterprise dr, suite 100 |
aliso viejo, CA 92656
|
6197314188
|
|
MDR Report Key | 11363723 |
MDR Text Key | 233035611 |
Report Number | 3006179046-2021-00142 |
Device Sequence Number | 1 |
Product Code |
KTT
|
UDI-Device Identifier | 00887517021687 |
UDI-Public | 887517021687 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K192181 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,user faci |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
02/22/2021 |
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 | LP4.5-MLT4B |
Device Lot Number | 0071317AAA |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
01/27/2021 |
Initial Date FDA Received | 02/22/2021 |
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;
|
Patient Age | 6 YR |
Patient Weight | 39 |
|
|