MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2004-12-07 for CHOLESTRAK * manufactured by Accutech, Llc.
[383385]
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Patient Sequence No: 1, Text Type: D, B5
Report Number | MW1033964 |
MDR Report Key | 562787 |
Date Received | 2004-12-07 |
Date of Report | 2004-11-18 |
Date of Event | 2004-01-01 |
Date Added to Maude | 2005-01-04 |
Event Key | 0 |
Report Source Code | Voluntary report |
Manufacturer Link | N |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | PATIENT |
Health Professional | 3 |
Initial Report to FDA | 0 |
Report to FDA | 0 |
Event Location | 3 |
Single Use | 0 |
Previous Use Code | 0 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | CHOLESTRAK |
Generic Name | CHOLESTEROL MEASURING DEVICE |
Product Code | NFX |
Date Received | 2004-12-07 |
Model Number | * |
Catalog Number | * |
Lot Number | UPC 7-8376280202 |
ID Number | * |
Device Expiration Date | 2002-08-01 |
Operator | LAY USER/PATIENT |
Device Availability | Y |
Implant Flag | N |
Date Removed | * |
Device Sequence No | 1 |
Device Event Key | 552519 |
Manufacturer | ACCUTECH, LLC |
Manufacturer Address | 2641 LA MIRADA DRIVE VISTA CA 92081 US |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2004-12-07 |