MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2019-06-04 for UN3 SCREWS, SELF-DRILLING, 1.5X4MM, 5/P 56-15904 manufactured by Stryker Leibinger Freiburg.
| Report Number | 0008010177-2019-00027 |
| MDR Report Key | 8666255 |
| Report Source | DISTRIBUTOR |
| Date Received | 2019-06-04 |
| Date of Report | 2019-11-08 |
| Date of Event | 2019-02-20 |
| Date Mfgr Received | 2019-05-10 |
| Date Added to Maude | 2019-06-04 |
| 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 | MR. KELLI DYKSTRA |
| Manufacturer Street | BOETZINGERSTR. 41 |
| Manufacturer City | FREIBURG D-79111 |
| Manufacturer Postal | D-79111 |
| Manufacturer Phone | 76145120 |
| Manufacturer G1 | STRYKER LEIBINGER FREIBURG |
| Manufacturer Street | BOETZINGERSTR. 41 |
| Manufacturer City | FREIBURG D-79111 |
| Manufacturer Postal Code | D-79111 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | UN3 SCREWS, SELF-DRILLING, 1.5X4MM, 5/P |
| Generic Name | IMPLANT |
| Product Code | HBW |
| Date Received | 2019-06-04 |
| Catalog Number | 56-15904 |
| Lot Number | 1000295618 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STRYKER LEIBINGER FREIBURG |
| Manufacturer Address | BOETZINGERSTR. 41 FREIBURG D-79111 D-79111 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-06-04 |