inventory control form - arthrex

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Page 1 of 6 This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document. Date: Hospital: Surgeon: Patient Information: © 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404 Inventory Control Form: Clavicle Plate System (AR-2650S) Central Third Plates, Left QTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI AR-2650CL Large Curve 8 86 mm AR-2651CL Medium Curve 8 93 mm AR-2652CL Small Curve 8 98 mm AR-2653CL Medium Curve 10 120 mm AR-2654CL X-Small Curve 8 87 mm AR-2655CL Small Curve 7 76 mm AR-2680ST Straight 7 76 mm Central Third Plates, Right QTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI AR-2650CR Large Curve 8 86 mm AR-2651CR Medium Curve 8 93 mm AR-2652CR Small Curve 8 98 mm AR-2653CR Medium Curve 10 120 mm AR-2654CR X-Small Curve 8 87 mm AR-2655CR Small Curve 7 76 mm

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Page 1: Inventory Control Form - Arthrex

Page 1 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

Central Third Plates, LeftQTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI

AR-2650CL Large Curve 8 86 mm

AR-2651CL Medium Curve 8 93 mm

AR-2652CL Small Curve 8 98 mm

AR-2653CL Medium Curve 10 120 mm

AR-2654CL X-Small Curve 8 87 mm

AR-2655CL Small Curve 7 76 mm

AR-2680ST Straight 7 76 mm

Central Third Plates, RightQTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI

AR-2650CR Large Curve 8 86 mm

AR-2651CR Medium Curve 8 93 mm

AR-2652CR Small Curve 8 98 mm

AR-2653CR Medium Curve 10 120 mm

AR-2654CR X-Small Curve 8 87 mm

AR-2655CR Small Curve 7 76 mm

Page 2: Inventory Control Form - Arthrex

Page 2 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

Distal Third Plates, LeftQTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI

AR-2622DL Distal 22˚ 5 70 mm

AR-2656DL Small 5 70 mm

AR-2657DL Medium 8 100 mm

AR-2685DL-10 Large 10 126 mm

Distal Third Plates, RightQTY PRODUCT # DESCRIPTION HOLES LENGTH PRICE LOT# UDI

AR-2622DR Distal 22˚ 5 70 mm

AR-2656DR Small 5 70 mm

AR-2657DR Medium 8 100 mm

AR-2685DR-10 Large 10 126 mm

Coracoid FixationQTY PRODUCT # DESCRIPTION PRICE LOT# UDI

AR-2272 Drill Pin, 3.7 mm

AR-2658TR Knotless Distal Clavicle Plate ButtonTightRope® Implant

AR-2658 Distal Clavicle Plate Button

AR-2658T Knotless Distal Clavicle Plate Button Assembly

AR-2270 Dog Bone™ Button

Page 3: Inventory Control Form - Arthrex

Page 3 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

Fragment Screw, 2.5 mmQTY PRODUCT # LENGTH PRICE LOT# UDI

AR-2665-10H 10 mm

AR-2665-12H 12 mm

AR-2665-14H 14 mm

AR-2665-16H 16 mm

AR-2665-18H 18 mm

AR-2665-20H 20 mm

AR-2665-22H 22 mm

AR-2665-24H 24 mm

Low Profile Screws, Locking, 2.7 mmQTY PRODUCT # LENGTH PRICE LOT# UDI

AR-8827L-08 8 mm

AR-8827L-10 10 mm

AR-8827L-12 12 mm

AR-8827L-14 14 mm

AR-8827L-16 16 mm

AR-8827L-18 18 mm

AR-8827L-20 20 mm

AR-8827L-22 22 mm

AR-8827L-24 24 mm

Page 4: Inventory Control Form - Arthrex

Page 4 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

Low Profile Screw, Nonlocking, Cortical, 2.7 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8827-10 10 mm

AR-8827-12 12 mm

AR-8827-14 14 mm

AR-8827-16 16 mm

Low Profile Screw, Nonlocking, Cancellous, 3 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8830-10 10 mm

AR-8830-12 12 mm

AR-8830-14 14 mm

AR-8830-16 16 mm

AR-8830-18 18 mm

AR-8830-20 20 mm

AR-8830-22 22 mm

AR-8830-24 24 mm

Low Profile Screw, Nonlocking, Cortical, 2.7 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8827-18 18 mm

AR-8827-20 20 mm

AR-8827-22 22 mm

AR-8827-24 24 mm

Low Profile Screw, Locking, 3.5 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8835L-08 8 mm

AR-8835L-10 10 mm

AR-8835L-12 12 mm

AR-8835L-14 14 mm

AR-8835L-16 16 mm

AR-8835L-18 18 mm

AR-8835L-20 20 mm

AR-8835L-22 22 mm

AR-8835L-24 24 mm

Page 5: Inventory Control Form - Arthrex

Page 5 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

Low Profile Screw, Nonlocking, Cortical, 3.5 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8835-08 8 mm

AR-8835-10 10 mm

AR-8835-12 12 mm

AR-8835-14 14 mm

AR-8835-16 16 mm

AR-8835-18 18 mm

AR-8835-20 20 mm

AR-8835-22 22 mm

AR-8835-24 24 mm

AR-8835-26 26 mm

AR-8835-28 28 mm

AR-8835-30 30 mm

Low Profile Screw, Nonlocking, Cancellous, 4 mmQTY PRODUCT # LENGTH LOT# UDI

AR-8840-10 10 mm

AR-8840-12 12 mm

AR-8840-14 14 mm

AR-8840-16 16 mm

AR-8840-18 18 mm

AR-8840-20 20 mm

AR-8840-22 22 mm

AR-8840-24 24 mm

Page 6: Inventory Control Form - Arthrex

Page 6 of 6

This document may contain privileged and confidential information and/or protected health information (PHI) intended solely for the use of the recipient(s) named above. If you are not the recipient, or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, dissemination, distribution, printing or copying of this document is strictly prohibited. If you have received this transmission in error, please notify the sender immediately and permanently delete/destroy this document.

Date:

Hospital:

Surgeon:

Patient Information:

© 2019 Arthrex, Inc. (USA) LF1-0255-EN_G; To Order, Call: 1-800-934-4404

Inventory Control Form: Clavicle Plate System (AR-2650S)

DisposablesQTY PRODUCT # DESCRIPTION LOT# UDI

AR-2663 K-Wire, 0.062 in × 3 in

AR-13226 BB-Tak

AR-8943-13 Drill Bit, graduated, 2.5 mm

AR-8943-16 Drill Bit, graduated, 2 mm

AR-4068-05SD SutureLasso™ SD Wire Loop

AR-2257D-24 Drill, cannulated for AC repair, 2.4 mm

AR-2257D-30 Drill, cannulated for AC repair, 3 mm

AR-2669 Drill Bit, 2 mm

AR-2752 Step Drill for 2.5 mm Fragment Screws

AR-7237-7 FiberTape® Suture, 7 in (blue)

AR-7237-7T TigerTape™ Suture, 7 in (white/black)

AR-7275 FiberTape Suture Loop

AR-7275T TigerTape Suture Loop

AR-7210 #5 FiberWire® Suture, 38 in