*

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 2004-03-03 for * manufactured by *.

MAUDE Entry Details

Report Number2150060-2004-00008
MDR Report Key517791
Report Source06
Date Received2004-03-03
Date of Event2003-11-10
Date Mfgr Received2003-12-15
Date Added to Maude2004-03-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer Street14605 28TH AVE N
Manufacturer CityMINNEAPOLIS MN 55357
Manufacturer CountryUS
Manufacturer Postal55357
Manufacturer Phone7635533300
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name*
Generic Name*
Product CodeLIF
Date Received2004-03-03
Model Number*
Catalog Number*
Lot Number*
ID Number*
Device Availability*
Device Eval'ed by MfgrR
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key506819
Manufacturer*
Manufacturer Address* * *


Patients

Patient NumberTreatmentOutcomeDate
10 2004-03-03

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