| Brand Name | MODULAR POST, 30MM |
| Common Device Name | SHOULDR PROSTH, REVERSE CONFIG |
| 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 | 24895145 |
| Report Number | 1220246-2026-02241 |
| Device Sequence Number | 10489025 |
| Product Code |
PHX
|
| UDI-Device Identifier | 00888867341852 |
| UDI-Public | (01)00888867341852(11)240801(17)290731(10)1644912347 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | AU |
| PMA/510(K) Number | K193372 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Explanted Year | 2026 |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Company Representative |
| Initial Reporter Occupation |
Administrator/Supervisor
|
| Type of Report
| Initial |
| Report Date (Section B) |
04/16/2026 |
| 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 | MODULAR POST, 30MM |
| Device Catalogue Number | AR-9582-30 |
| Device Lot Number | 1644912347 |
| Was Device Available for Evaluation? |
No
|
| Distributor Facility Aware Date | 03/27/2026 |
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/27/2026 |
| Initial Report FDA Received Date | 04/16/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 08/01/2024 |
| 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 |
|
|