PINNACLE CORE CASE 222000110

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-05 for PINNACLE CORE CASE 222000110 manufactured by Depuy Ireland - 9616671.

Event Text Entries

[185095145] Product complaint #: (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[185095146] It was reported that the inside of tray brackets peeling.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1818910-2020-06897
MDR Report Key9792577
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-05
Date of Report2020-02-18
Date Mfgr Received2020-03-23
Device Manufacturer Date2013-11-01
Date Added to Maude2020-03-05
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. KARA DIITY- BOVARD
Manufacturer Street1210 WARD AVENUE
Manufacturer CityWEST CHESTER IN 193800988
Manufacturer CountryUS
Manufacturer Postal193800988
Manufacturer Phone6107428552
Manufacturer G1DEPUY ORTHOPAEDICS, INC. 1818910
Manufacturer StreetST. ANTHONY ROAD
Manufacturer CityLEEDS IN 465810988
Manufacturer CountryUS
Manufacturer Postal Code465810988
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePINNACLE CORE CASE
Generic NameINSTRUMENT CASE
Product CodeFSM
Date Received2020-03-05
Returned To Mfg2020-02-25
Catalog Number222000110
Lot NumberPV0042969
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerDEPUY IRELAND - 9616671
Manufacturer AddressLOUGHBEG RINGASKIDDY CO. CORK IN EI


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-05

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