MAUDE MDR 8298026

MDR report key
8298026
Report number
1018233-2019-00560
Event key
0
Event type
3
Date of event
2019-01-11
Date received
2019-02-01
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
YONIC ANDERSON
Address
8195 INDUSTRIAL BLVD COVINGTON GA 30014 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BARD? BRACHYSOURCE? I-125 IMPLANT SEEDS IN READYLINK?SOURE LINKBARD BRACHYTHERAPY, INC. -1424526KNXSTM1251RL11663063Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-02-010

Event Narratives#

N

Patient 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE FILED.

D

Patient 1

IT WAS REPORTED THAT THERE WAS A WHITE FOREIGN MATERIAL FOUND ON THE TRAY.