MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-06-25 for ELECTRODE Q TRACE GOLD 5500 ECL BULK 30807732 manufactured by Covidien.
| Report Number | 1219103-2019-00236 |
| MDR Report Key | 8732591 |
| Date Received | 2019-06-25 |
| Date of Report | 2019-06-25 |
| Date of Event | 2019-03-19 |
| Date Mfgr Received | 2019-06-13 |
| Date Added to Maude | 2019-06-25 |
| 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 | JILL SARAIVA |
| Manufacturer Street | 15 HAMPSHIRE STREET |
| Manufacturer City | MANSFIELD MA 02048 |
| Manufacturer Country | US |
| Manufacturer Postal | 02048 |
| Manufacturer Phone | 5086183640 |
| Manufacturer G1 | COVIDIEN |
| Manufacturer Street | 2 LUDLOW PARKWAY |
| Manufacturer City | CHICOPEE MA 01022 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 01022 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | ELECTRODE Q TRACE GOLD 5500 ECL BULK |
| Generic Name | ELECTRODE, ELECTROCARDIOGRAPH |
| Product Code | DRX |
| Date Received | 2019-06-25 |
| Model Number | 30807732 |
| Catalog Number | 30807732 |
| Lot Number | 734239X |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COVIDIEN |
| Manufacturer Address | 2 LUDLOW PARKWAY CHICOPEE MA 01022 US 01022 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-06-25 |