DIMENSION? DF105A SMN 10483822

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2019-04-29 for DIMENSION? DF105A SMN 10483822 manufactured by Siemens Healthcare Diagnostics Inc..

MAUDE Entry Details

Report Number2517506-2019-00174
MDR Report Key8561220
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2019-04-29
Date of Report2019-05-31
Date of Event2019-04-08
Date Mfgr Received2019-05-06
Device Manufacturer Date2018-07-09
Date Added to Maude2019-04-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJAMES MORGERA
Manufacturer Street500 GBC DRIVE PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal197146101
Manufacturer Phone3026318356
Manufacturer G1SIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Street500 GBC DRIVE PO BOX 6101
Manufacturer CityNEWARK DE 197146101
Manufacturer CountryUS
Manufacturer Postal Code197146101
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDIMENSION?
Generic NameDIMENSION? HB1C HEMOGLOBIN A1C KIT
Product CodeLCP
Date Received2019-04-29
Catalog NumberDF105A SMN 10483822
Lot NumberGC9190
Device Expiration Date2019-07-09
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS HEALTHCARE DIAGNOSTICS INC.
Manufacturer Address500 GBC DRIVE PO BOX 6101 NEWARK DE 197146101 US 197146101


Patients

Patient NumberTreatmentOutcomeDate
10 2019-04-29

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