MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 08 report with the FDA on 2006-04-10 for manufactured by .
| Report Number | 9680515-2006-00003 |
| MDR Report Key | 703073 |
| Report Source | 08 |
| Date Received | 2006-04-10 |
| Date Mfgr Received | 2006-03-14 |
| Device Manufacturer Date | 2005-03-01 |
| Date Added to Maude | 2006-04-26 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 0 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Street | KANTSTRASSE 33 |
| Manufacturer City | WURMLINGEN 78573 |
| Manufacturer Country | GM |
| Manufacturer Postal | 78573 |
| Manufacturer Phone | 461965760 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Remedial Action | RL |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Product Code | EMH |
| Date Received | 2006-04-10 |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Device Sequence No | 1 |
| Device Event Key | 683764 |
| Baseline Brand Name | WINER GRASPING FORCEPS, IN LINE RATCHET 5MM 33CM |
| Baseline Generic Name | JARIT ENDOSCOPIC INSTRUMENTS |
| Baseline Model No | * |
| Baseline Catalog No | 600-123 |
| Baseline ID | * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2006-04-10 |