MAUDE MDR 7145617

MDR report key
7145617
Report number
9612030-2017-05260
Event key
0
Event type
3
Date received
2017-12-26
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
EDWARD ALMEIDA
Address
15 HAMPSHIRE STREET MANSFIELD MA 02048 US
Phone
508-508-5084
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DEVONMARKER, SKINCOVIDIENFZZ31145827311458271715777464N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-12-260

Event Narratives#

N

Patient 1

SUBMIT DATE: 12/26/2017. AN INVESTIGATION IS CURRENTLY UNDER WAY; UPON COMPLETION THE RESULTS WILL BE FORWARDED. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

D

Patient 1

THE CUSTOMER STATES THAT THE TEAM HAS FOUND OUR SURGICAL MARKERS TO BE BLEEDING AND LEAVING A JAGGED LINE FOR THE INCISION PLACEMENT.