BEUDAMED
    FDA Adverse Event Other Summary report: N

    RSP

    MDR report key: 672440 · Received February 6, 2006

    Report

    Report Number
    1644408-2005-00072
    Event Type
    Other
    Date Received
    February 6, 2006
    Date of Event
    November 29, 2005
    Report Date
    November 30, 2005
    Manufacturer
    ENCORE MEDICAL, L.P.
    Product Code
    KWR
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A 32 HUMERAL STANDARD SOCKET INSERT SURGICALLY REVISED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RSP SHOULDER PROSTHESIS KWR ENCORE MEDICAL, L.P. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention