MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-06-27 for IV START KIT MICRO DYND1905A manufactured by Medline Industries Inc..
| Report Number | 8739078 |
| MDR Report Key | 8739078 |
| Date Received | 2019-06-27 |
| Date of Report | 2019-06-24 |
| Date of Event | 2019-06-20 |
| Report Date | 2019-06-24 |
| Date Reported to FDA | 2019-06-24 |
| Date Reported to Mfgr | 2019-06-27 |
| Date Added to Maude | 2019-06-27 |
| 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 | BIOMEDICAL ENGINEER |
| 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 | IV START KIT MICRO |
| Generic Name | KIT, IV START |
| Product Code | LRS |
| Date Received | 2019-06-27 |
| Catalog Number | DYND1905A |
| Lot Number | 19DBL769 |
| Device Availability | Y |
| Device Age | 1 DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES INC. |
| Manufacturer Address | THREE LAKES DRIVE NORTHFIELD IL 60093 US 60093 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-06-27 |