Brand Name | AHTB UNIVERSAL HIP DISTRACTOR |
Type of Device | APPARATUS, TRACTION, NON-POWERED |
Manufacturer (Section D) |
SMITH & NEPHEW, INC. |
150 minuteman road |
andover MA 01810 |
|
Manufacturer (Section G) |
SMITH & NEPHEW, INC. |
150 minuteman road |
|
andover MA 01810 |
|
Manufacturer Contact |
jim
gonzales
|
7000 west william cannon drive |
austin, TX 78735
|
|
MDR Report Key | 7117468 |
MDR Text Key | 94985402 |
Report Number | 3003604053-2017-00335 |
Device Sequence Number | 1 |
Product Code |
HST
|
UDI-Device Identifier | 00885554024821 |
UDI-Public | (01)00885554024821 |
Combination Product (y/n) | N |
Reporter Country Code | DA |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
02/16/2018 |
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 Model Number | 72203270 |
Device Catalogue Number | 72203270 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 12/28/2017 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
12/12/2017 |
Initial Date FDA Received | 12/14/2017 |
Supplement Dates Manufacturer Received | 02/13/2018
|
Supplement Dates FDA Received | 02/16/2018
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |