MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2004-05-20 for * manufactured by *.
Report Number | 1018233-2004-00027 |
MDR Report Key | 528892 |
Report Source | 05 |
Date Received | 2004-05-20 |
Date of Event | 2004-01-24 |
Date Mfgr Received | 2004-04-27 |
Date Added to Maude | 2004-06-10 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 0 |
Manufacturer Contact | VIVIAN STEPHENS, MGR |
Manufacturer Street | 8195 INDUSTRIAL BLVD |
Manufacturer City | COVINGTON GA 30014 |
Manufacturer Country | US |
Manufacturer Postal | 30014 |
Manufacturer Phone | 7707846902 |
Manufacturer G1 | BARD MEDICAL |
Manufacturer Street | KM 7 CARRETERA INTERNACIONAL |
Manufacturer City | NOGALES, SONORA 84000 |
Manufacturer Country | MX |
Manufacturer Postal Code | 84000 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | * |
Generic Name | * |
Product Code | EBR |
Date Received | 2004-05-20 |
Model Number | * |
Catalog Number | * |
Lot Number | * |
ID Number | * |
Device Availability | * |
Device Eval'ed by Mfgr | R |
Implant Flag | N |
Date Removed | * |
Device Sequence No | 1 |
Device Event Key | 518080 |
Manufacturer | * |
Manufacturer Address | * * US |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2004-05-20 |