Brand Name | ACROMIONIZER,4.0 EP-1,DSPL BL |
Type of Device | SAW, POWERED, AND ACCESSORIES |
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 west william cannon drive |
austin, TX 78735
|
|
MDR Report Key | 7061607 |
MDR Text Key | 93304344 |
Report Number | 1219602-2017-01482 |
Device Sequence Number | 1 |
Product Code |
HAB
|
UDI-Device Identifier | 03596010251541 |
UDI-Public | (01)03596010251541(17)220324(10)50654918 |
Combination Product (y/n) | N |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign,user faci |
Type of Report
| Initial,Followup |
Report Date |
01/10/2018 |
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 Expiration Date | 03/24/2022 |
Device Model Number | 7205326 |
Device Catalogue Number | 7205326 |
Device Lot Number | 50654918 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 12/07/2017 |
Initial Date Manufacturer Received |
11/20/2017 |
Initial Date FDA Received | 11/27/2017 |
Supplement Dates Manufacturer Received | 01/02/2018
|
Supplement Dates FDA Received | 01/10/2018
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 03/24/2017 |
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 |