BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) TOTAL A-CLASS HEAD

    MDR report key: 6075732 · Received November 3, 2016

    Report

    Report Number
    3010536692-2016-01351
    Event Type
    Injury
    Date Received
    November 3, 2016
    Date of Event
    June 15, 2012
    Report Date
    October 19, 2016
    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

    ALLEGEDLY THE PATIENT WAS REVISED DUE TO THE FOLLOWING MOM COMPLICATIONS: PAIN AND DECREASED MOBILITY (RIGHT).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    726512 CONSERVE(R) TOTAL A-CLASS HEAD HIP COMPONENT JDL MICROPORT ORTHOPEDICS INC. 019784316

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention