Brand Name | LRG. HUDSON TO 1/4 SQ. ADAPTER |
Type of Device | LRG. HUDSON ADAPTER |
Manufacturer (Section D) |
ORTHOPEDIATRICS, CORP |
2850 frontier drive |
warsaw IN 46582 |
|
Manufacturer (Section G) |
ORTHOPEDIATRICS, CORP |
2850 frontier drive |
|
warsaw IN 46582 |
|
Manufacturer Contact |
james
gunnels
|
2850 frontier drive |
warsaw, IN 46582
|
|
MDR Report Key | 12454476 |
MDR Text Key | 274788283 |
Report Number | 3006460162-2021-00037 |
Device Sequence Number | 1 |
Product Code |
NKB
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative |
Reporter Occupation |
Other
|
Type of Report
| Initial |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 09/10/2021 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
No Information
|
Device Model Number | 01-1003-5102 |
Device Catalogue Number | 01-1003-5102 |
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
Patient Age | 13 YR |
Patient Weight | 45 |
|
|