| Brand Name | POWERPICK, 45 DEG |
| Common Device Name | BURR, SURGICAL, GENERAL & PLASTIC SURGERY |
| Manufacturer (Section D) |
| ARTHREX, INC. |
| 1370 creekside boulevard |
| naples FL 34108 1945 |
|
| Manufacturer (Section G) |
| ARTHREX, INC. |
| 1370 creekside boulevard |
|
| naples FL 34108 1945 |
|
| Manufacturer Contact |
|
| MDR Report Key | 16582261 |
| Report Number | 1220246-2023-06460 |
| Device Sequence Number | 4748084 |
| Product Code |
GFF
|
| UDI-Device Identifier | 00888867042926 |
| UDI-Public | 00888867042926 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Company Representative |
| Initial Reporter Occupation |
Administrator/Supervisor
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/21/2023 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Model Number | POWERPICK, 45 DEG |
| Device Catalogue Number | AR-8150PX-45 |
| Device Lot Number | 15025764 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/01/2023 |
| Initial Report FDA Received Date | 03/21/2023 |
| Date Device Manufactured | 11/21/2022 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Sex | Unknown |
|
|