BEUDAMED
    FDA Adverse Event Summary report: N

    EXP SINGLE SET SCREW 5.5 SS

    MDR report key: 2112502 · Received April 6, 2011

    Report

    Report Number
    1526439-2011-00047
    Date Received
    April 6, 2011
    Manufacturer
    DEPUY SPINE, INC.
    Product Code
    KWP
    PMA / PMN Number
    K041119
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PLEASE REFER TO 1526439-2011-00045 FOR DETAILS.

    Description of Event or Problem · 1

    PLEASE REFER TO 1526439-2011-00045 FOR DETAILS. DEVICE 3 OF 3. FOR ADD'L PRODUCTS SEE: 1526439-2011-00045 AND 1526439-2011-00046.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EXP SINGLE SET SCREW 5.5 SS FIXATION DEVICE KWP DEPUY SPINE, INC. NA RE103072

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention