Brand Name | JRNY UNI TIBIAL BASE RM/LL SZ 4 |
Type of Device | PROSTHESIS, KNEE, FEMOROTIBIAL, NON-CONSTRAINED, CEMENTED, METAL/POLYMER |
Manufacturer (Section D) |
SMITH & NEPHEW, INC. |
1450 brooks road |
memphis TN 38116 |
|
MDR Report Key | 7614167 |
MDR Text Key | 111487824 |
Report Number | 1020279-2018-01162 |
Device Sequence Number | 1 |
Product Code |
HSX
|
UDI-Device Identifier | 00885556088296 |
UDI-Public | 00885556088296 |
Combination Product (y/n) | N |
PMA/PMN Number | K102069 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Type of Report
| Initial,Followup |
Report Date |
10/01/2018 |
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 | 08/31/2024 |
Device Catalogue Number | 71422434 |
Device Lot Number | 14JM01136 |
Initial Date Manufacturer Received |
06/04/2018 |
Initial Date FDA Received | 06/19/2018 |
Supplement Dates Manufacturer Received | 06/04/2018
|
Supplement Dates FDA Received | 10/01/2018
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 55 YR |
|
|