Brand Name | SYMPHYSIS PLATE, 6-HOLE |
Type of Device | SYMPHYSIS PLATE, 6-HOLE |
Manufacturer (Section D) |
I.T.S. GMBH |
autal 28 |
lassnitzh[?]he, styria 8301 |
AU 8301 |
|
Manufacturer (Section G) |
I.T.S. GMBH |
autal 28 |
|
lassnitzh[?]he, styria 8301 |
AU
8301
|
|
Manufacturer Contact |
florian
grill
|
autal 28 |
lassnitzh[?]he, styria 8301
|
AU
8301
|
|
MDR Report Key | 12932327 |
MDR Text Key | 283245254 |
Report Number | 3004369035-2021-00009 |
Device Sequence Number | 1 |
Product Code |
HRS
|
UDI-Device Identifier | 09120034302961 |
UDI-Public | 09120034302961 |
Combination Product (y/n) | N |
Reporter Country Code | GM |
PMA/PMN Number | K063166 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Distributor |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
11/29/2021 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 12/06/2021 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | 21161-6 |
Device Catalogue Number | 21161-6 |
Date Manufacturer Received | 11/10/2021 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
|
|