BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) PLUS CUP

    MDR report key: 4241453 · Received November 10, 2014

    Report

    Report Number
    3010536692-2014-01580
    Event Type
    Injury
    Date Received
    November 10, 2014
    Date of Event
    March 25, 2014
    Report Date
    October 14, 2014
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    KXA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IS THE SAME EVENT AS 3010536692-2014-01581.

    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
    721873 CONSERVE(R) PLUS CUP HIP COMPONENT KXA MICROPORT ORTHOPEDICS INC. 1418630

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Required Intervention