MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2005-07-13 for manufactured by .

MAUDE Entry Details

Report Number2250052-2005-00303
MDR Report Key787158
Report Source05,06
Date Received2005-07-13
Date Mfgr Received2005-06-17
Date Added to Maude2006-11-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag0
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA0
Event Location0
Manufacturer ContactLAURA VELLUCCI, PH.D
Manufacturer Street1001 US HWY 202
Manufacturer CityRARITAN NJ 08669
Manufacturer CountryUS
Manufacturer Postal08669
Manufacturer Phone9082188532
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionRP
Previous Use Code3
Event Type3
Type of Report3

Device Details

Product CodeJTL
Date Received2005-07-13
Device Eval'ed by MfgrY
Implant FlagN
Device Sequence No1
Device Event Key774920
Baseline Brand NameORTHO SUMMIT PROCESSOR
Baseline Generic NameELISA MICROWELL PLATE PROCESSOR
Baseline Model No7003015
Baseline Catalog No936480
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2005-07-13

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