MICROSHOX GT PYLON SPS CATALOG

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2007-04-24 for MICROSHOX GT PYLON SPS CATALOG manufactured by Design Co.

Event Text Entries

[616701] Prosthetic shock pylon for amputees failure in field. Breakage due to thin aluminum wall section. Sixty-six pieces in field to be returned (recalled) asap. Product microshox gt-140, external product gt-190, gt-250, gt-350. (do not have all the details on failed product).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1042774
MDR Report Key844460
Date Received2007-04-24
Date of Report2007-04-24
Date Added to Maude2007-05-07
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameMICROSHOX
Generic NameGT-140, GT-190, GT-250, GT-350
Product CodeISS
Date Received2007-04-24
Model NumberGT PYLON
Catalog NumberSPS CATALOG
Lot Number9/06 / 2/07
ID Number*
Device Availability*
Device Age*
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key831647
ManufacturerDESIGN CO
Manufacturer Address2055 E RIO SALADO PKWY #102 TEMPE AZ 85281 US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2007-04-24

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