FDA Adverse Event Injury Summary report: N

ADVANCE(R) EVOLUTION(R) PIN PACK***

MDR report key: 4235842 · Received November 7, 2014

Report

Report Number
3010536692-2014-01570
Event Type
Injury
Date Received
November 7, 2014
Date of Event
February 3, 2014
Report Date
October 8, 2014
Manufacturer
MICROPORT ORTHOPEDICS INC.
Product Code
LHX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINT DATABASE WAS REVIEWED AND ANALYSIS SHOWED NO TREND FOR ITEM/ LOT.

Additional Manufacturer Narrative · 1

THIS REPORT WILL BE UPDATED WHEN INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 3010536692-2014-01356_01, -01566, -01567, -01568, -01569, -01571.

Description of Event or Problem · 1

ALLEGEDLY THE PATIENT WAS REVISED DUE TO A SIZING ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
716498 ADVANCE(R) EVOLUTION(R) PIN PACK*** KNEE INSTRUMENT LHX MICROPORT ORTHOPEDICS INC. 1464747

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention