MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2019-10-16 for X-ALT HIP 932-40-756 manufactured by Encore Medical L.p..
| Report Number | 1644408-2019-01004 |
| MDR Report Key | 9197682 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2019-10-16 |
| Date of Report | 2019-10-16 |
| Date of Event | 2019-09-18 |
| Date Mfgr Received | 2019-09-18 |
| Device Manufacturer Date | 2019-06-19 |
| Date Added to Maude | 2019-10-16 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | TEFFANY HUTTO |
| Manufacturer Street | 9800 METRIC BLVD |
| Manufacturer City | AUSTIN, TX 78758-5445 |
| Manufacturer Country | US |
| Manufacturer G1 | ENCORE MEDICAL L.P. |
| Manufacturer Street | 9800 METRIC BLVD |
| Manufacturer City | AUSTIN, TX 78758-5445 |
| Manufacturer Country | US |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | X-ALT HIP |
| Generic Name | LINER 10 DEG HOODED-NEU, MP9, HXE-PLUS, 40MM |
| Product Code | OQH |
| Date Received | 2019-10-16 |
| Model Number | 932-40-756 |
| Catalog Number | 932-40-756 |
| Lot Number | 815N2010 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ENCORE MEDICAL L.P. |
| Manufacturer Address | 9800 METRIC BLVD AUSTIN, TX 78758-5445 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 400 | 1. Hospitalization; 2. Required No Informationntervention | 2019-10-16 |