Brand Name | TWNFX TI 5.0 STR ANCHR W/2 ULTRB STR N |
Type of Device | FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE |
Manufacturer (Section D) |
SMITH & NEPHEW, INC. |
130 forbes boulevard |
mansfield MA 02048 |
|
Manufacturer (Section G) |
SMITH & NEPHEW, INC. |
130 forbes boulevard |
|
mansfield MA 02048 |
|
Manufacturer Contact |
jim
gonzales
|
7000 w william cannon drive |
austin, TX 78735
|
|
MDR Report Key | 6816059 |
MDR Text Key | 83627951 |
Report Number | 1219602-2017-01022 |
Device Sequence Number | 1 |
Product Code |
MBI
|
UDI-Device Identifier | 03596010532206 |
UDI-Public | (01)03596010532206(17)220221(10)50647571 |
Combination Product (y/n) | N |
PMA/PMN Number | K972326 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,health professional,o |
Reporter Occupation |
Health Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
10/20/2017 |
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
|
Device Operator |
Health Professional
|
Device Model Number | 7210708 |
Device Catalogue Number | 7210708 |
Device Lot Number | 50647571 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 09/14/2017 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
08/23/2017 |
Initial Date FDA Received | 08/24/2017 |
Supplement Dates Manufacturer Received | 09/20/2017 10/20/2017
|
Supplement Dates FDA Received | 09/27/2017 10/20/2017
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Age | 50 YR |