MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2019-06-03 for EZYDOSE PILL CRUSHER 71091 manufactured by Apothecary Products, Llc.
| Report Number | 0002183416-2019-00004 |
| MDR Report Key | 8664286 |
| Report Source | COMPANY REPRESENTATIVE,CONSUM |
| Date Received | 2019-06-03 |
| Date of Report | 2019-06-03 |
| Date of Event | 2019-05-14 |
| Date Mfgr Received | 2019-05-15 |
| Date Added to Maude | 2019-06-03 |
| 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 PAXIA HER |
| Manufacturer Street | 11750 12TH AVE. S |
| Manufacturer City | BURNSVILLE MN 55337 |
| Manufacturer Country | US |
| Manufacturer Postal | 55337 |
| Manufacturer Phone | 9528088364 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | EZYDOSE PILL CRUSHER |
| Generic Name | PILL CRUSHER |
| Product Code | OHY |
| Date Received | 2019-06-03 |
| Returned To Mfg | 2019-05-31 |
| Model Number | 71091 |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | APOTHECARY PRODUCTS, LLC |
| Manufacturer Address | 11750 12TH AVE S. BURNSVILLE MN 55337 US 55337 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-06-03 |