UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-05-12 for UNK manufactured by Unk.

Event Text Entries

[22172723] Aneurysm dilitation anterior venous graft right arm.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number167251
MDR Report Key167251
Date Received1998-05-12
Date of Report1998-04-01
Date of Event1998-03-24
Date Facility Aware1998-03-24
Report Date1998-04-01
Date Reported to FDA1998-04-01
Date Added to Maude1998-05-14
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameUNK
Generic NameVENOUS GRAFT
Product CodeFIQ
Date Received1998-05-12
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeUNKNOWN
Implant FlagY
Date Removed*
Device Sequence No1
Device Event Key162750
ManufacturerUNK
Manufacturer AddressUNK UNK UNK *


Patients

Patient NumberTreatmentOutcomeDate
10 1998-05-12

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