MAUDE MDR 8735927

MDR report key
8735927
Report number
1037905-2019-00352
Event key
0
Event type
3
Date received
2019-06-26
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. SCOTTIE FARIOLE
Address
4900 BETHANIA STATION RD WINSTON-SALEM NC 27105 US
Phone
336-336-3367
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CAPTURA PRO? BIOPSY FORCEPS WITHOUT SPIKEPTS ENDOSCOPIC GRASPING/CUTTING INSTRUMENT, NON-POWERED, EXEMPTCOOK ENDOSCOPYPTSBF-2.4SL-230-20UNKNOWNR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-06-260

Event Narratives#

No narrative records found.