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 2002-10-30 for manufactured by .

MAUDE Entry Details

Report Number2431497-2002-00001
MDR Report Key426793
Report Source06
Date Received2002-10-30
Date of Event2002-10-11
Date Mfgr Received2002-10-29
Date Added to Maude2002-11-13
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 ContactMARTIN PRENSKE
Manufacturer Street29 WELLS AVE
Manufacturer CityYONKERS NY 10701
Manufacturer CountryUS
Manufacturer Postal10701
Manufacturer Phone9149632040
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Product CodeIQB
Date Received2002-10-30
Device Eval'ed by MfgrR
Implant FlagN
Device Sequence No1
Device Event Key414758
Baseline Brand NameSKILL-CARE CORP.
Baseline Generic NameSOFT-BELT-SELF SIDE RELEASE BUCKLE
Baseline Model No00671509103907
Baseline Catalog No301270
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2002-10-30

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