MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,user f report with the FDA on 2019-06-10 for TUBING, OXYGEN SUPPLY 7', W/CC 1115CC manufactured by Teleflex Medical.
| Report Number | 3004365956-2019-00151 |
| MDR Report Key | 8684658 |
| Report Source | COMPANY REPRESENTATIVE,USER F |
| Date Received | 2019-06-10 |
| Date of Report | 2019-05-20 |
| Date of Event | 2019-05-17 |
| Date Mfgr Received | 2019-06-17 |
| Device Manufacturer Date | 2018-09-18 |
| Date Added to Maude | 2019-06-10 |
| 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 | KATHARINE TARPLEY |
| Manufacturer Street | 3015 CARRINGTON MILL BLVD |
| Manufacturer City | MORRISVILLE NC 27560 |
| Manufacturer Country | US |
| Manufacturer Postal | 27560 |
| Manufacturer Phone | 9194334854 |
| Manufacturer G1 | TELEFLEX MEDICAL |
| Manufacturer Street | PARQUE INDUSTRIAL FINSA |
| Manufacturer City | NUEVO LAREDO 88275 |
| Manufacturer Country | MX |
| Manufacturer Postal Code | 88275 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TUBING, OXYGEN SUPPLY 7', W/CC |
| Generic Name | OXYGEN DELIVERY DEVICE |
| Product Code | BYX |
| Date Received | 2019-06-10 |
| Returned To Mfg | 2019-05-29 |
| Catalog Number | 1115CC |
| Lot Number | 74J1801844 |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | TELEFLEX MEDICAL |
| Manufacturer Address | RESEARCH TRIANGLE PARK NC |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-06-10 |