BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PATH(R) THREAD CUP ADAPTOR

    MDR report key: 3827975 · Received May 22, 2014

    Report

    Report Number
    3010536692-2014-00860
    Event Type
    Malfunction
    Date Received
    May 22, 2014
    Date of Event
    March 28, 2014
    Report Date
    April 22, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    KWA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    ALLEGEDLY THE ADAPTOR STICKS WITH THE HANDLE. HAPPENED IN LAB.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    304745 PATH(R) THREAD CUP ADAPTOR HIP INSTRUMENT KWA MICROPORT ORTHOPEDICS INC. NI

    Patients

    Seq Age Sex Outcome Treatment
    1