5.5 EXP VERSE FEN SCR 8.0X40 199723840

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2019-10-15 for 5.5 EXP VERSE FEN SCR 8.0X40 199723840 manufactured by Medos International Sàrl Ch.

MAUDE Entry Details

Report Number1526439-2019-52241
MDR Report Key9191848
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2019-10-15
Date of Report2019-09-18
Date of Event2019-09-18
Date Mfgr Received2019-11-18
Device Manufacturer Date2019-05-15
Date Added to Maude2019-10-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
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
Manufacturer ContactKARA DITTY-BOVARD
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone6103142063
Manufacturer G1MEDOS INT SPINE
Manufacturer StreetCHEMIN BLANC 38
Manufacturer CityLE LOCLE
Manufacturer CountrySZ
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name5.5 EXP VERSE FEN SCR 8.0X40
Generic NameBONE CEMENT, POSTERIOR SCREW AUGMENTATION
Product CodePML
Date Received2019-10-15
Model Number199723840
Catalog Number199723840
Lot Number241986
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMEDOS INTERNATIONAL SàRL CH
Manufacturer AddressCHEMIN-BLANC 38 LE LOCLE 02400 SZ 02400


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-10-15

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