BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CLP HIP INSTRUMENTATION

    MDR report key: 1220355 · Received October 31, 2008

    Report

    Report Number
    1644408-2008-00378
    Event Type
    Malfunction
    Date Received
    October 31, 2008
    Date of Event
    October 10, 2008
    Report Date
    October 13, 2008
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    HWB
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.

    Description of Event or Problem · 1

    TRYING TO EXTRACT STEM AND HOOK OF CLP STEM EXTRACTOR BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CLP HIP INSTRUMENTATION EXTRACTION HOOK HWB ENCORE MEDICAL, L.P.

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR