BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HIP

    MDR report key: 1961736 · Received January 11, 2011

    Report

    Report Number
    1644408-2011-00024
    Event Type
    Malfunction
    Date Received
    January 11, 2011
    Date of Event
    January 4, 2011
    Report Date
    January 4, 2011
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    HTQ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    INSTRUMENT FAILURE - THE INTERNAL SCREW CAPTURE FOR 28 MM MP6 ACETABULAR TRIAL BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HIP LINEAR BROACH HIP INSTRUMENT HTQ ENCORE MEDICAL, L.P. 32393L33

    Patients

    Seq Age Sex Outcome Treatment
    1