MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-11-07 for ATRIEVE 381003004 manufactured by Argon.
[91325353]
During procedure marker clip came off of the product.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5073158 |
| MDR Report Key | 7006525 |
| Date Received | 2017-11-07 |
| Date of Report | 2017-11-03 |
| Date of Event | 2017-10-26 |
| Date Added to Maude | 2017-11-07 |
| 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 | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | ATRIEVE |
| Generic Name | VASCULAR SNARE KIT |
| Product Code | MMX |
| Date Received | 2017-11-07 |
| Returned To Mfg | 2017-11-02 |
| Model Number | 381003004 |
| Lot Number | 11091754 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ARGON |
| Manufacturer Address | US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2017-11-07 |