MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2019-07-17 for EZY DOSE PILL PLANNER 67585WM manufactured by Apothecary Products, Llc.
| Report Number | 0002183416-2019-00006 |
| MDR Report Key | 8800357 |
| Report Source | CONSUMER |
| Date Received | 2019-07-17 |
| Date of Report | 2019-07-17 |
| Date of Event | 2019-06-16 |
| Date Mfgr Received | 2019-06-17 |
| Date Added to Maude | 2019-07-17 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | PAXIA HER |
| Manufacturer Street | 11750 12TH AVE S |
| Manufacturer City | BURNSVILLE MN 55337 |
| Manufacturer Country | US |
| Manufacturer Postal | 55337 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | EZY DOSE PILL PLANNER |
| Generic Name | PILL PLANNER |
| Product Code | NXB |
| Date Received | 2019-07-17 |
| Returned To Mfg | 2019-07-02 |
| Model Number | 67585WM |
| Device Availability | R |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | APOTHECARY PRODUCTS, LLC |
| Manufacturer Address | 11750 12TH AVE S BURNSVILLE MN 55337 US 55337 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-07-17 |