MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,study report with the FDA on 2020-03-31 for PFC*SIGMA/OV/DOME PAT 3PEG,41 96-0103 960103 manufactured by Depuy Orthopaedics Inc Us.
| Report Number | 1818910-2020-09712 |
| MDR Report Key | 9903311 |
| Report Source | HEALTH PROFESSIONAL,STUDY |
| Date Received | 2020-03-31 |
| Date of Report | 2020-03-13 |
| Date of Event | 2020-03-05 |
| Date Mfgr Received | 2020-03-13 |
| Device Manufacturer Date | 2012-02-28 |
| Date Added to Maude | 2020-03-31 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | KARA DITTY-BOVARD |
| Manufacturer Street | 700 ORTHOPAEDIC DRIVE |
| Manufacturer City | WARSAW IN 465810988 |
| Manufacturer Country | US |
| Manufacturer Postal | 465810988 |
| Manufacturer Phone | 6107428552 |
| Manufacturer G1 | DEPUY IRELAND 9616671 |
| Manufacturer Street | LOUGHBEG, RINGASKIDDY CO. |
| Manufacturer City | CORK |
| Manufacturer Country | EI |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PFC*SIGMA/OV/DOME PAT 3PEG,41 |
| Generic Name | SIGMA KNEE PRIMARY : KNEE PATELLA |
| Product Code | JWH |
| Date Received | 2020-03-31 |
| Model Number | 96-0103 |
| Catalog Number | 960103 |
| Lot Number | 3427982 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | DEPUY ORTHOPAEDICS INC US |
| Manufacturer Address | 700 ORTHOPAEDIC DRIVE WARSAW IN 465810988 US 465810988 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-31 |