ANTI-ALK (D5F3) RABBIT MONOCLONAL PRIMARY ANTIBODY 06679072001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign report with the FDA on 2019-06-06 for ANTI-ALK (D5F3) RABBIT MONOCLONAL PRIMARY ANTIBODY 06679072001 manufactured by Ventana Medical Systems, Inc.

MAUDE Entry Details

Report Number2028492-2019-00009
MDR Report Key8674703
Report SourceFOREIGN
Date Received2019-06-06
Date of Report2019-07-01
Date of Event2019-05-09
Date Mfgr Received2019-05-09
Date Added to Maude2019-06-06
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 ContactNA STACIE-ANN CREIGHTON
Manufacturer Street1910 E INNOVATION PARK DRIVE NA
Manufacturer CityTUSCON AZ 85755
Manufacturer CountryUS
Manufacturer Postal85755
Manufacturer Phone9082537112
Manufacturer G1NA
Manufacturer StreetNA NA
Manufacturer CityNA
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameANTI-ALK (D5F3) RABBIT MONOCLONAL PRIMARY ANTIBODY
Generic NameIMMUNOHISTOCHEMISTRY ASSAY, ANTIBODY, ANAPLASTIC LYMPHOMA KINASE
Product CodePKW
Date Received2019-06-06
Model NumberNA
Catalog Number06679072001
Lot NumberNI
OperatorHEALTH PROFESSIONAL
Device Availability*
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerVENTANA MEDICAL SYSTEMS, INC
Manufacturer Address1910 E INNOVATION PARK DR NA TUCSON AZ 85755 US 85755


Patients

Patient NumberTreatmentOutcomeDate
10 2019-06-06

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