Brand Name | XMCP |
Type of Device | BONE SCREW |
Manufacturer (Section D) |
EXTREMITY MEDICAL, LLC. |
300 interpace parkway |
suite 410 |
parsippany NJ 07054 |
|
Manufacturer Contact |
brian
smekal
|
300 interpace parkway |
suite 410 |
parsippany, NJ 07054
|
9735888980
|
|
MDR Report Key | 16283520 |
MDR Text Key | 308630102 |
Report Number | 3007289093-2022-00016 |
Device Sequence Number | 1 |
Product Code |
HWC
|
UDI-Device Identifier | 00842078108055 |
UDI-Public | 00842078108055 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K121417 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Distributor |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
02/02/2023 |
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 | 120-12530 |
Device Catalogue Number | 120-12530 |
Initial Date Manufacturer Received |
11/18/2022 |
Initial Date FDA Received | 02/02/2023 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|