MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2001-10-10 for manufactured by .

MAUDE Entry Details

Report Number1043572-2001-00007
MDR Report Key356342
Report Source07
Date Received2001-10-10
Date of Event2001-08-22
Date Mfgr Received2001-09-14
Device Manufacturer Date1998-03-01
Date Added to Maude2001-10-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag0
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA0
Event Location0
Manufacturer ContactROBERT MCCALL
Manufacturer Street2720 GUNTER PARK DRIVE E
Manufacturer CityMONTGOMERY AL 36109
Manufacturer CountryUS
Manufacturer Postal36109
Manufacturer Phone3342133150
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Product CodeFSE
Date Received2001-10-10
Device Eval'ed by MfgrY
Implant FlagN
Device Sequence No1
Device Event Key338755
Baseline Brand Name*
Baseline Generic NameOR TABLE
Baseline Model No308S
Baseline Catalog No*
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2001-10-10

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