VITAL SIGNS PEDIATRIC ANESTHESIA BREATHING CIRCUIT G96LXXXA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-06-20 for VITAL SIGNS PEDIATRIC ANESTHESIA BREATHING CIRCUIT G96LXXXA manufactured by Vyaire Medical.

MAUDE Entry Details

Report Number8030673-2019-00044
MDR Report Key8718529
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-06-20
Date of Report2019-05-25
Date of Event2019-05-25
Date Mfgr Received2019-05-25
Date Added to Maude2019-06-20
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 ContactMR. STANLEY TAN
Manufacturer Street22745 SAVI RANCH PKWY
Manufacturer CityYORBA LINDA CA 92887
Manufacturer CountryUS
Manufacturer Postal92887
Manufacturer Phone7149193324
Manufacturer G1PRODUCTOS UROLOGOS DE MEXICO S.A. DE C.V.
Manufacturer Street# 85 PARQUE INDUSTRIAL
Manufacturer CityMEXICALI, 21397
Manufacturer CountryMX
Manufacturer Postal Code21397
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVITAL SIGNS PEDIATRIC ANESTHESIA BREATHING CIRCUIT
Generic NameANESTHESIA CIRCUIT, PEDIATRIC
Product CodeCAI
Date Received2019-06-20
Catalog NumberG96LXXXA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerVYAIRE MEDICAL
Manufacturer Address22745 SAVI RANCH PKWY YORBA LINDA CA 92887 US 92887


Patients

Patient NumberTreatmentOutcomeDate
10 2019-06-20

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