FDA Adverse Event Other Summary report: N

CORMET RESURFACING

MDR report key: 3022612 · Received March 22, 2013

Report

Report Number
9614209-2013-00007
Event Type
Other
Date Received
March 22, 2013
Date of Event
March 3, 2011
Report Date
February 26, 2013
Manufacturer
CORIN LTD
Product Code
NXT
PMA / PMN Number
K082525
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). PT NOTES, PATHOLOGY REPORTS, POST PRIMARY AND PRE-REVISION X-RAYS, EXPLANT AND REASON FOR REVISION TO BE REQUESTED. INCIDENT IS OUTSIDE USA.

Description of Event or Problem · 1

CORMET REVISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
119081 CORMET RESURFACING NXT METAL ON METAL RE-SURFACING NXT CORIN LTD 179.252B LBNX

Patients

Seq Age Sex Outcome Treatment
1 40 YR Hospitalization ASSOCIATED CORMET HEAD - 179.004. LOT LTCR