MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01 report with the FDA on 2000-03-29 for VISION manufactured by Smv International.
[19897025]
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Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9615727-2000-00009 |
| MDR Report Key | 271933 |
| Report Source | 01 |
| Date Received | 2000-03-29 |
| Date of Report | 2000-03-28 |
| Date of Event | 2000-03-17 |
| Date Facility Aware | 2000-03-17 |
| Report Date | 2000-03-29 |
| Date Reported to Mfgr | 2000-03-17 |
| Date Added to Maude | 2000-04-05 |
| 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 | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MARCO TIRELLI |
| Manufacturer Street | 105 AV. MORANE-SAULNIER |
| Manufacturer City | BUC CEDEX 78534 |
| Manufacturer Country | FR |
| Manufacturer Postal | 78534 |
| Manufacturer Phone | 0849100 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | VISION |
| Generic Name | COMPUTER |
| Product Code | JWM |
| Date Received | 2000-03-29 |
| Model Number | NA |
| Catalog Number | NA |
| Lot Number | NA |
| ID Number | NA |
| Operator | OTHER |
| Device Availability | * |
| Device Age | NA |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 263252 |
| Manufacturer | SMV INTERNATIONAL |
| Manufacturer Address | 105 AV. MORANE-SAULNIER BUC CEDEX FR 78534 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2000-03-29 |