FDA.reportPublic FDA data

MAUDE MDR 1073733

MDR report key
1073733
Report number
9617604-2008-00073
Event key
0
Event type
3
Date received
2008-06-27
Adverse event
0
Product problem
0
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
0
Event location
0

Manufacturer Contact#

Contact
TIM MATSON
Address
10 BOWMAN DR KEENE NH 03431 US
Phone
603-603-6033
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BZTNN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12008-06-270

Event Narratives#

N

Patient 1

EVAL - OTHER: THE SAMPLE INVOLVED IN THS EVENT IS IN THE PROCESS OF BEING FORWARDED TO THE MFG SITE. UPON COMPLETION OF THE INVESTIGATION, A FOLLOW-UP PREPORT WILL BE SUBMITTED. I CAN REPORT THAT WE HAVE NOT HAD ANY OTHER REPORTS ON THIS DEVICE LOT NUMBER.