BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 4113352 · Received September 24, 2014

    Report

    Report Number
    3010536692-2014-01415
    Event Type
    Injury
    Date Received
    September 24, 2014
    Date of Event
    August 12, 2014
    Report Date
    September 3, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SAME EVENT AS 3010536692-2014-01414.

    Description of Event or Problem · 1

    ALLEGEDLY, PATIENT COMPLAINED OF CHRONIC HIP PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    595542 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 056339971

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Required Intervention