RIGID PNEUMATIC PROBE M0068407330

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-04-27 for RIGID PNEUMATIC PROBE M0068407330 manufactured by Boston Scientific.

Event Text Entries

[106967945] Boston scientific 1. 0mm x 570mm rigid pneumatic probe opened for case. While plastic roller adjuster could not be moved.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5076828
MDR Report Key7471920
Date Received2018-04-27
Date of Report2018-04-06
Date of Event2018-04-05
Date Added to Maude2018-04-30
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameRIGID PNEUMATIC PROBE
Generic NameLITHOTRIPTOR ELECTRO - HYDRAULIC
Product CodeFFK
Date Received2018-04-27
Model NumberM0068407330
Catalog NumberM0068407330
Lot Number21773500
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerBOSTON SCIENTIFIC
Manufacturer AddressMARLBOROUGH MA 01752 US 01752


Patients

Patient NumberTreatmentOutcomeDate
10 2018-04-27

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