MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-06-17 for ULTRAVAC 2110-10EC manufactured by Megadyne Medical Products, Inc..
| Report Number | 8703775 |
| MDR Report Key | 8703775 |
| Date Received | 2019-06-17 |
| Date of Report | 2019-05-21 |
| Date of Event | 2019-05-06 |
| Report Date | 2019-05-21 |
| Date Reported to FDA | 2019-05-21 |
| Date Reported to Mfgr | 2019-06-17 |
| Date Added to Maude | 2019-06-17 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ULTRAVAC |
| Generic Name | APPARATUS, EXHAUST, SURGICAL |
| Product Code | FYD |
| Date Received | 2019-06-17 |
| Model Number | 2110-10EC |
| Lot Number | 7270 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEGADYNE MEDICAL PRODUCTS, INC. |
| Manufacturer Address | 11506 S STATE ST DRAPER UT 84020 US 84020 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-06-17 |