MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2010-11-23 for MIRA CR4000 OPHTHALMIC CRYO UNIT CR4010 manufactured by Mira, Inc..
[21430101]
Excessive leaking from probe tip.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 1218813-2010-00017 |
MDR Report Key | 1910839 |
Report Source | 06 |
Date Received | 2010-11-23 |
Date of Report | 2010-11-19 |
Date of Event | 2010-06-22 |
Device Manufacturer Date | 2009-01-01 |
Date Added to Maude | 2011-02-25 |
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 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 0 |
Event Location | 0 |
Manufacturer Street | 414 QUAKER HIGHWAY |
Manufacturer City | UXBRIDGE MA 01527 |
Manufacturer Country | US |
Manufacturer Postal | 01527 |
Single Use | 3 |
Remedial Action | MA |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | MIRA CR4000 OPHTHALMIC CRYO UNIT |
Product Code | HPS |
Date Received | 2010-11-23 |
Model Number | CR4010 |
Catalog Number | CR4010 |
Lot Number | 0109 |
Operator | HEALTH PROFESSIONAL |
Device Availability | Y |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | MIRA, INC. |
Manufacturer Address | UXBRIDGE MA US |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2010-11-23 |