FDA Adverse Event
Injury
Summary report: N
AMISTEM H SIZE 3 STD
MDR report key: 3350350
·
Received September 6, 2013
Report
- Report Number
- 3005180920-2013-00102
- Event Type
- Injury
- Date Received
- September 6, 2013
- Manufacturer
- MEDACTA INTERNATIONAL, SA
- Product Code
- LZO
- PMA / PMN Number
- K093944
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DOCUMENT REVIEW: AMISTEM H FEMORAL STEM SIZE 3 STD- REF. 01.18.133 / LOT 130595 (70 STEMS PRODUCED): ALL PARAMETERS WERE FOUND TO BE IN ACCORDANCE WITH THE SPECIFICATIONS VALID AT THE TIME OF MANUFACTURING, INCLUDED WASHING AND STERILIZATION CYCLES. THE 48 STEMS BELONGING TO THIS LOT HAVE BEEN ALREADY IMPLANTED AND NO OTHER INCIDENTS HAVE BEEN ALREADY IMPLANTED AND NO OTHER INCIDENTS HAVE BEEN REPORTED UP TO NOW. FROM THE DATA COLLECTED, WE DO NOT HAVE EVIDENCES THAT THE EVENT IS DEVICE RELATED, BUT IT IS MORE LIKELY TO A MISTAKE DURING THE PRIMARY SURGERY.
Description of Event or Problem · 1
(B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 444445 | AMISTEM H SIZE 3 STD | FEMORAL CEMENTLESS STEM | LZO | MEDACTA INTERNATIONAL, SA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |