MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-04-24 for N/A R10439011 manufactured by Sterilmed, Inc..
[106307329]
Patient Sequence No: 1, Text Type: N, H10
[106307330]
Poor signal. Ep lab reviewed. When the catheter was connected, the image displayed was poor. Trouble shooting was unsuccessful. The catheter was removed and a new catheter was used. No injury to the patient.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 7453747 |
| MDR Report Key | 7453747 |
| Date Received | 2018-04-24 |
| Date of Report | 2018-04-11 |
| Date of Event | 2018-03-22 |
| Report Date | 2018-04-11 |
| Date Reported to FDA | 2018-04-11 |
| Date Reported to Mfgr | 2018-04-11 |
| Date Added to Maude | 2018-04-24 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 0 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| 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 | 3 |
| Brand Name | N/A |
| Generic Name | REPROCESSED INTRAVASCULAR ULTRASOUND CATHETER |
| Product Code | OWQ |
| Date Received | 2018-04-24 |
| Model Number | R10439011 |
| Catalog Number | R10439011 |
| Lot Number | 2018229 |
| Operator | PHYSICIAN |
| Device Availability | Y |
| Device Age | 1 DY |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STERILMED, INC. |
| Manufacturer Address | 11400 73RD AVE N STE 100 MAPLE GROVE MN 55369 US 55369 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-04-24 |