| Brand Name | HEALIX ADVANCE PERMACORD |
| Common Device Name | Fastener, fixation, biodegradable, soft tissue |
| Manufacturer (Section D) |
| DePuy Mitek LLC US |
| 325 paramount drive |
| raynham MA 02767 |
|
| Manufacturer Contact |
|
elba
bello
|
| 325 paramount drive |
| raynham, MA 02767
|
|
+1(908)386-3534
|
|
| MDR Report Key | 50438895 |
| Report Number | 1221934-2026-03791 |
| Device Sequence Number | 13158841 |
| Product Code |
MAI
|
| UDI-Device Identifier | 10886705024803 |
| UDI-Public | (01)10886705024803(10)281L832(17)270331 |
| Combination Product (Y/N) | N |
| Initial Reporter State | KY |
| Initial Reporter Country | US |
| PMA/510(K) Number | K073412 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Company Representative |
| Type of Report
| Initial |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Catalogue Number | 223128 |
| Device Lot Number | 281L832 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/17/2026 |
| Initial Report FDA Received Date | 08/25/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 04/16/2024 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|