MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-06-28 for VETPRO DC VETPRO DC, 76" REACH SYSTEM W/TWO STUD MOUNT P7017V-P manufactured by Midmark Corporation.
| Report Number | 1423380-2019-00003 |
| MDR Report Key | 8743890 |
| Date Received | 2019-06-28 |
| Date of Report | 2019-05-28 |
| Date of Event | 2019-04-25 |
| Date Mfgr Received | 2019-04-29 |
| Date Added to Maude | 2019-06-28 |
| 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 |
| Reporter Occupation | DENTIST |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ADAM FORESMAN |
| Manufacturer Street | 1001 ASBURY DR |
| Manufacturer City | BUFFALO GROVE IL 60089 |
| Manufacturer Country | US |
| Manufacturer Postal | 60089 |
| Manufacturer Phone | 2242204329 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | VETPRO DC |
| Generic Name | VETPRO DC |
| Product Code | EAP |
| Date Received | 2019-06-28 |
| Model Number | VETPRO DC, 76" REACH SYSTEM W/TWO STUD MOUNT |
| Catalog Number | P7017V-P |
| Device Availability | N |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MIDMARK CORPORATION |
| Manufacturer Address | 1001 ASBURY DR BUFFALO GROVE IL 60089 US 60089 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-06-28 |