MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-01-28 for DISPOSABLE ENDOSCOPIC CLEANING BRUSH DCB-DV-50 manufactured by Cook Ireland Ltd.
[134279312]
Pma/510k # class i n/a. (b)(4). Investigation is currently in progress.
Patient Sequence No: 1, Text Type: N, H10
[134279313]
Brushes snapped while being guided into endoscope channel.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3001845648-2019-00034 |
| MDR Report Key | 8281740 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2019-01-28 |
| Date of Report | 2019-02-25 |
| Date of Event | 2018-12-28 |
| Date Facility Aware | 2019-01-28 |
| Date Mfgr Received | 2018-12-31 |
| Date Added to Maude | 2019-01-28 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. HEATHER RYAN |
| Manufacturer Street | O HALLORAN ROAD NATIONAL TECHNOLOGY PARK |
| Manufacturer City | LIMERICK |
| Manufacturer Phone | 061334440 |
| Manufacturer G1 | COOK IRELAND LTD |
| Manufacturer Street | O HALLORAN ROAD NATIONAL TECHNOLOGY PARK |
| Manufacturer City | LIMERICK |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DISPOSABLE ENDOSCOPIC CLEANING BRUSH |
| Generic Name | MNL ACCESSORIES, CLEANING BRUSHES, FOR ENDOSCOPES |
| Product Code | MNL |
| Date Received | 2019-01-28 |
| Catalog Number | DCB-DV-50 |
| Lot Number | UNKNOWN |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COOK IRELAND LTD |
| Manufacturer Address | O HALLORAN ROAD NATIONAL TECHNOLOGY PARK LIMERICK |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-01-28 |