BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CONSERVE(R) PLUS CUP

    MDR report key: 7527288 · Received May 18, 2018

    Report

    Report Number
    3010536692-2018-00654
    Event Type
    Injury
    Date Received
    May 18, 2018
    Report Date
    May 18, 2018
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    KWA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ALLEGEDLY THE PATIENT IS EXPERIENCING THE FOLLOWING MOM COMPLICATIONS: PAIN AND DECREASED MOBILITY. ADDITIONAL INFORMATION RECEIVED FROM LITIGATION ON 05/09/2018. ALLEGEDLY THE PATIENT WAS REVISED DUE TO MOM COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    368797 CONSERVE(R) PLUS CUP HIP COMPONENT KWA MICROPORT ORTHOPEDICS INC. 3802-1152 03210614

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention