FDA.reportPublic FDA data

MAUDE MDR 5061805

MDR report key
5061805
Report number
3003898360-2015-00640
Event key
0
Event type
3
Date of event
2015-08-27
Date received
2015-09-08
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
EFFIE JEFFERSON
Address
3015 CARRINGTON MILL BLVD MORRISVILLE NC 27560 US
Phone
919-919-9194
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DERMAHOOK 1/2 HOOK 10 PKG/BX 6 HKS/PKGTELEFLEX MEDICALGDG38280573E1500060R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-09-080

Event Narratives#

No narrative records found.