FDA Adverse Event Injury Summary report: N

CONSERVE(R) PLUS CUP

MDR report key: 3800306 · Received May 8, 2014

Report

Report Number
3010536692-2014-00741
Event Type
Injury
Date Received
May 8, 2014
Date of Event
May 14, 2012
Report Date
April 11, 2014
Manufacturer
MICROPORT ORTHOPEDICS INC.
Product Code
KWA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS IS THE SAME EVENT AS 3010536692-2014-00742.

Description of Event or Problem · 1

ALLEGEDLY THE PATIENT WAS REVISED DUE TO MOM COMPLICATIONS (RIGHT).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
277666 CONSERVE(R) PLUS CUP HIP COMPONENT KWA MICROPORT ORTHOPEDICS INC. 027405333

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention