MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2019-06-28 for ATELLICA IM VITAMIN B12 N/A 10995715 manufactured by Siemens Healthcare Diagnostics, Inc..
| Report Number | 1219913-2019-00119 |
| MDR Report Key | 8746334 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL,U |
| Date Received | 2019-06-28 |
| Date of Report | 2019-09-30 |
| Date of Event | 2019-06-05 |
| Date Mfgr Received | 2019-09-04 |
| Device Manufacturer Date | 2019-01-02 |
| 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 | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. STACY LOUKOS |
| Manufacturer Street | 333 CONEY STREET |
| Manufacturer City | EAST WALPOLE MA 02032 |
| Manufacturer Country | US |
| Manufacturer Postal | 02032 |
| Manufacturer Phone | 5086608576 |
| Manufacturer G1 | SIEMENS HEALTHCARE DIAGNOSTICS, INC. |
| Manufacturer Street | 333 CONEY STREET |
| Manufacturer City | EAST WALPOLE MA 02032 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 02032 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ATELLICA IM VITAMIN B12 |
| Generic Name | VITAMIN B12 IMMUNOASSAY |
| Product Code | CDD |
| Date Received | 2019-06-28 |
| Model Number | N/A |
| Catalog Number | 10995715 |
| Lot Number | 28162253 |
| Device Expiration Date | 2019-12-02 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS HEALTHCARE DIAGNOSTICS, INC. |
| Manufacturer Address | 511 BENEDICT AVENUE TARRYTOWN NY 105915097 US 105915097 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-06-28 |