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 .
Report Number | 2431497-2002-00001 |
MDR Report Key | 426793 |
Report Source | 06 |
Date Received | 2002-10-30 |
Date of Event | 2002-10-11 |
Date Mfgr Received | 2002-10-29 |
Date Added to Maude | 2002-11-13 |
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 | MARTIN PRENSKE |
Manufacturer Street | 29 WELLS AVE |
Manufacturer City | YONKERS NY 10701 |
Manufacturer Country | US |
Manufacturer Postal | 10701 |
Manufacturer Phone | 9149632040 |
Manufacturer G1 | * |
Manufacturer Street | * |
Manufacturer City | * |
Manufacturer Country | * |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Product Code | IQB |
Date Received | 2002-10-30 |
Device Eval'ed by Mfgr | R |
Implant Flag | N |
Device Sequence No | 1 |
Device Event Key | 414758 |
Baseline Brand Name | SKILL-CARE CORP. |
Baseline Generic Name | SOFT-BELT-SELF SIDE RELEASE BUCKLE |
Baseline Model No | 00671509103907 |
Baseline Catalog No | 301270 |
Baseline ID | * |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2002-10-30 |