BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 4141042 · Received October 3, 2014

    Report

    Report Number
    3010536692-2014-01450
    Event Type
    Injury
    Date Received
    October 3, 2014
    Date of Event
    August 28, 2014
    Report Date
    September 11, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IS THE SAME EVENT 3010536692-2014-01451.

    Description of Event or Problem · 1

    ALLEGEDLY, HIP REVISED DUE TO MOM COMPLICATIONS. (LEFT)

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    617843 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 107482918

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention