FDA Adverse Event Other Summary report: N

HALLU-C PLATE SIZE 1 LEFT

MDR report key: 1414776 · Received July 14, 2009

Report

Report Number
9615741-2009-00021
Event Type
Other
Date Received
July 14, 2009
Date of Event
July 1, 2009
Report Date
July 14, 2009
Manufacturer
NEWDEAL S.A.
Product Code
HRS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFO.

Description of Event or Problem · 1

THE REPORTER STATED THAT THE DEVICE WAS IMPLANTED ON (B)(6) 2009 HAS BROKEN AND THE PT HAS HAD REVISION SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HALLU-C PLATE SIZE 1 LEFT NA HRS NEWDEAL S.A. ECV2

Patients

Seq Age Sex Outcome Treatment
1