BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 5063162 · Received September 8, 2015

    Report

    Report Number
    3010536692-2015-01671
    Event Type
    Injury
    Date Received
    September 8, 2015
    Date of Event
    June 4, 2013
    Report Date
    September 8, 2015
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JDL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THIS IS THE SAME EVENT AS 3010536692-2015-01670.

    Description of Event or Problem · 1

    ALLEGEDLY, PATIENT WAS REVISED DUE TO MOM COMPLICATIONS: PAIN; DIFFICULTY AMBULATION. RIGHT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    594242 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 106382899

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Required Intervention