BEUDAMED
    FDA Adverse Event Other Summary report: N

    SHOULDER SYSTEM

    MDR report key: 1031772 · Received April 18, 2008

    Report

    Report Number
    1644408-2008-00118
    Event Type
    Other
    Date Received
    April 18, 2008
    Date of Event
    March 24, 2008
    Report Date
    April 17, 2008
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    HSD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REVISION SURGERY - FAILED TSA CONVERTED TO AND RSP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SHOULDER SYSTEM HUMERAL STEM, PLASMA HSD ENCORE MEDICAL, L.P. 53882860

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention