* 2219

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-11-12 for * 2219 manufactured by Addto Inc..

Event Text Entries

[153685] Package contained a strand of human hair. Item is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1015121
MDR Report Key200769
Date Received1998-11-12
Date of Report1998-11-09
Date Added to Maude1998-12-10
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand Name*
Generic NameCATHETER ADAPTER
Product CodeEYI
Date Received1998-11-12
Model Number*
Catalog Number2219
Lot Number083
ID NumberNSN 6615BP6134004
Device AvailabilityY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key195025
ManufacturerADDTO INC.
Manufacturer Address816 N KOSTNER AVE. CHICAGO IL 60651 US


Patients

Patient NumberTreatmentOutcomeDate
10 1998-11-12

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