MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2005-11-01 for ENHANCED EXTERNAL COUNTERPULSATION TS4 * manufactured by Vasomedical, Inc..
[413500]
Pt completed four treatments before returning to optometrist for a previously scheduled post-cataract evaluation. Hemorrhaging evident in both eyes, retinal artery aneurysm in right eye.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2435300-2005-00005 |
| MDR Report Key | 644873 |
| Report Source | 05,06 |
| Date Received | 2005-11-01 |
| Date of Report | 2005-10-31 |
| Date of Event | 2005-09-26 |
| Date Mfgr Received | 2005-09-30 |
| Device Manufacturer Date | 2004-05-01 |
| Date Added to Maude | 2005-11-08 |
| 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 Street | 180 LINDEN AVE. |
| Manufacturer City | WESTBURY NY 11590 |
| Manufacturer Country | US |
| Manufacturer Postal | 11590 |
| Manufacturer Phone | 5169974600 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ENHANCED EXTERNAL COUNTERPULSATION |
| Generic Name | DEVICE, EXTERNAL, COUNTER-PULSATING |
| Product Code | DRN |
| Date Received | 2005-11-01 |
| Model Number | TS4 |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | N |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 634361 |
| Manufacturer | VASOMEDICAL, INC. |
| Manufacturer Address | * WESTBURY NY * US |
| Baseline Brand Name | ENHANCED EXTERNAL COUNTERPULSATION |
| Baseline Generic Name | DEVICE, COUNTER-PULSATING, EXTERNAL |
| Baseline Model No | TS4 |
| Baseline Catalog No | * |
| Baseline ID | * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2005-11-01 |