MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-08-05 for CENTURION IV SECUREMENT KIT WITH EXTENSION SET IVS3265 manufactured by Centurion Medical Products Corporation.
| Report Number | MW5088828 |
| MDR Report Key | 8866222 |
| Date Received | 2019-08-05 |
| Date of Report | 2019-08-02 |
| Date of Event | 2019-06-21 |
| Date Added to Maude | 2019-08-06 |
| Event Key | 0 |
| Report Source Code | Voluntary 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 | CENTURION IV SECUREMENT KIT WITH EXTENSION SET |
| Generic Name | DEVICE, INTRAVASCULAR CATHETER SECUREMENT |
| Product Code | KMK |
| Date Received | 2019-08-05 |
| Returned To Mfg | 2019-08-02 |
| Catalog Number | IVS3265 |
| Lot Number | 2019021490 |
| Device Expiration Date | 2019-11-30 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | CENTURION MEDICAL PRODUCTS CORPORATION |
| Manufacturer Address | WILLIAMSTON MI 48895 US 48895 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-08-05 |