BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL HEAD W/BFH

    MDR report key: 3970633 · Received July 31, 2014

    Report

    Report Number
    3010536692-2014-01046
    Event Type
    Injury
    Date Received
    July 31, 2014
    Date of Event
    June 12, 2014
    Report Date
    July 9, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    KWA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    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
    446667 CONSERVE(R) TOTAL HEAD W/BFH HIP COMPONENT KWA MICROPORT ORTHOPEDICS INC. 09495574

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Required Intervention