*

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00 report with the FDA on 2008-02-29 for * manufactured by Clinical Innovations, Llc.

Event Text Entries

[8032085] We have contacted the hospital several times, but as of the date of this filing, have not received any further info.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1722684-2008-00002
MDR Report Key1005270
Report Source00
Date Received2008-02-29
Date Mfgr Received2008-02-20
Date Added to Maude2008-03-04
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 Location0
Manufacturer ContactWM WALLACE
Manufacturer Street747 WEST 4170 SOUTH
Manufacturer CityMURRAY UT 84123
Manufacturer CountryUS
Manufacturer Postal84123
Manufacturer Phone8012688200
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name*
Generic Name*
Product CodeHGS
Date Received2008-02-29
Model Number*
Catalog Number*
Lot Number*
ID Number*
Device Availability*
Device Eval'ed by MfgrR
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key973824
ManufacturerCLINICAL INNOVATIONS, LLC
Manufacturer Address747 WEST 4170 SOUTH MURRAY UT 84123 US


Patients

Patient NumberTreatmentOutcomeDate
10 2008-02-29

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