MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 1999-10-20 for I.A. EXTENSION BOARD manufactured by Steris Corp..
| Report Number | 1043572-1999-00005 |
| MDR Report Key | 246692 |
| Report Source | 06 |
| Date Received | 1999-10-20 |
| Date of Event | 1999-09-16 |
| Date Mfgr Received | 1999-09-21 |
| Date Added to Maude | 1999-11-01 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 0 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | ROBERT MCCALL |
| Manufacturer Street | 2720 GUNTER PARK DR E |
| Manufacturer City | MONTGOMERY LA 36109 |
| Manufacturer Country | US |
| Manufacturer Postal | 36109 |
| Manufacturer Phone | 3342133150 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | I.A. EXTENSION BOARD |
| Generic Name | SURGICAL TABLE ACCESSORY |
| Product Code | FSE |
| Date Received | 1999-10-20 |
| Returned To Mfg | 1999-10-05 |
| Model Number | NA |
| Catalog Number | NA |
| Lot Number | NA |
| ID Number | NA |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 238975 |
| Manufacturer | STERIS CORP. |
| Manufacturer Address | 2720 GUNTER PARK DRIVE E. MONTGOMERY AL 36109 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1999-10-20 |