MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-07-01 for KARL STORZ 27033 17114-000 manufactured by .
| Report Number | 8770942 |
| MDR Report Key | 8770942 |
| Date Received | 2019-07-01 |
| Date of Report | 2019-06-28 |
| Date of Event | 2019-06-11 |
| Date Facility Aware | 2019-06-11 |
| Report Date | 2019-06-11 |
| Date Reported to FDA | 2019-06-24 |
| Date Reported to Mfgr | 2019-06-28 |
| Date Added to Maude | 2019-07-09 |
| 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 |
| 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 | 0 |
| Brand Name | KARL STORZ |
| Generic Name | THIN PEDI SYSTEM |
| Product Code | FBO |
| Date Received | 2019-07-01 |
| Model Number | 27033 |
| Catalog Number | 17114-000 |
| Lot Number | STZPDICYS-000 |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer Address | 1 S. LOS CARNEROS ROAD GOLETA CA 93117 US 93117 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization | 2019-07-01 |