FDA.reportPublic FDA data

MAUDE MDR 9182520

MDR report key
9182520
Report number
3010536692-2019-01087
Event key
0
Event type
3
Date received
2019-10-11
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
0
Event location
3

Manufacturer Contact#

Address
5677 AIRLINE ROAD ARLINGTON TN 38002 US
Phone
901-901-9018
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DYNASTY? BF SHELL 52MM GROUP DHIP COMPONENTMICROPORT ORTHOPEDICS INC.JDLDSBFGD52DSBFGD521101216630R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-1101. R

Event Narratives#

No narrative records found.