BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 4233564 · Received November 6, 2014

    Report

    Report Number
    3010536692-2014-01561
    Event Type
    Injury
    Date Received
    November 6, 2014
    Date of Event
    September 16, 2014
    Report Date
    October 8, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    HIP PAIN; REVISION SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    715780 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 116390097

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Required Intervention