Brand Name | ACETLR CUP HAP 56MM W/ IMPTR |
Type of Device | PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING |
Manufacturer (Section D) |
SMITH & NEPHEW ORTHOPAEDICS LTD |
aurora house |
spa park |
leamington spa CV31 3HL |
UK CV31 3HL |
|
Manufacturer (Section G) |
SMITH & NEPHEW ORTHOPAEDICS LTD |
aurora house |
spa park |
leamington spa CV31 3HL |
UK
CV31 3HL
|
|
Manufacturer Contact |
markus
poettker
|
schachenallee 29 |
aarau 5001
|
SZ
5001
|
|
MDR Report Key | 6864119 |
MDR Text Key | 86073973 |
Report Number | 3005975929-2017-00275 |
Device Sequence Number | 1 |
Product Code |
NXT
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P040033 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer,other |
Reporter Occupation |
Attorney
|
Type of Report
| Initial,Followup,Followup |
Report Date |
07/12/2018 |
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 Expiration Date | 03/31/2014 |
Device Catalogue Number | 74120156 |
Device Lot Number | 99364 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
09/06/2017 |
Initial Date FDA Received | 09/14/2017 |
Supplement Dates Manufacturer Received | 09/06/2017 09/06/2017
|
Supplement Dates FDA Received | 11/24/2017 07/12/2018
|
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 04/02/2009 |
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 |
Treatment | FEMORAL HEAD, PART AND LOT # UNKNOWN |
Patient Outcome(s) |
Hospitalization;
Required Intervention;
|
Patient Age | 55 YR |