BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COCR CONCENTRIC HUM HD 48MMX17MM SELEC

    MDR report key: 516031 · Received March 16, 2004

    Report

    Report Number
    2935620-2004-00021
    Event Type
    Injury
    Date Received
    March 16, 2004
    Date of Event
    February 5, 2004
    Report Date
    February 19, 2004
    Manufacturer
    CENTERPULSE ORTHOPEDICS, INC.
    Product Code
    KWS
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WAS REVISED IN 2004.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COCR CONCENTRIC HUM HD 48MMX17MM SELEC SHOULDER PROSTHESIS KWS CENTERPULSE ORTHOPEDICS, INC. NA 1529298

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Other