JAKO LARYNGEAL PROBE, ANGLED BE2847

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2000-04-28 for JAKO LARYNGEAL PROBE, ANGLED BE2847 manufactured by .

MAUDE Entry Details

• Report Number: 1423507-2000-00116
• MDR Report Key: 275840
• Report Source: 06
• Date Received: 2000-04-28
• Date of Report: 2000-04-28
• Date of Event: 2000-02-11
• Date Mfgr Received: 2000-04-25
• Date Added to Maude: 2000-05-03
• 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: 0
• Initial Report to FDA: 0
• Report to FDA: 3
• Event Location: 0
• Manufacturer Contact: PATRICIA SHARPE-GREGG
• Manufacturer Street: 1500 WAUKEGAN ROAD
• Manufacturer City: MCGAW PARK IL 60085
• Manufacturer Country: US
• Manufacturer Postal: 60085
• Manufacturer Phone: 8475783636
• Manufacturer G1: *
• Manufacturer Street: *
• Manufacturer City: *
• Manufacturer Country: *
• Single Use: 3
• Previous Use Code: 3
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: JAKO LARYNGEAL PROBE, ANGLED
• Generic Name: INSTRUMENT
• Product Code: KAK
• Date Received: 2000-04-28
• Model Number: BE2847
• Catalog Number: BE2847
• Lot Number: UNK
• ID Number: N/A
• Operator: HEALTH PROFESSIONAL
• Device Availability: N
• Device Eval'ed by Mfgr: R
• Implant Flag: N
• Date Removed: B
• Device Sequence No: 1
• Device Event Key: 263700
• Baseline Brand Name: JAKO LARYNGEAL PROBE, ANGLED
• Baseline Generic Name: INSTRUMENT
• Baseline Model No: BE2847
• Baseline Catalog No: BE2847
• Baseline Device Family: INSTRUMENT
• Baseline Shelf Life [Months]: NA
• Baseline PMA Flag: N
• Baseline 510K PMN: N
• Baseline Preamendment: Y
• Baseline Transitional: N
• 510k Exempt: N

Patients

Patient Number	Treatment	Outcome	Date
1	0	1. Other	2000-04-28