ACCESSORIES UNIVERSAL 100323C0 - RADIAL SETTING CLAMP 100323C0

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-08-14 for ACCESSORIES UNIVERSAL 100323C0 - RADIAL SETTING CLAMP 100323C0 manufactured by Holger Ullrich.

MAUDE Entry Details

Report Number8010652-2019-00024
MDR Report Key8892418
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2019-08-14
Date of Report2019-11-15
Date of Event2019-08-08
Date Mfgr Received2019-11-13
Date Added to Maude2019-08-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer StreetMAQUET GMBH KEHLER STRASSE 31,
Manufacturer CityRASTATT 76437
Manufacturer CountryGM
Manufacturer Postal76437
Manufacturer G1HOLGER ULLRICH
Manufacturer StreetMAQUET GMBH KEHLER STRASSE 31,
Manufacturer CityRASTATT 76437
Manufacturer CountryGM
Manufacturer Postal Code76437
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACCESSORIES UNIVERSAL
Generic NameTABLE AND ATTACHMENTS, OPERATING-ROOM
Product CodeBWN
Date Received2019-08-14
Model Number100323C0 - RADIAL SETTING CLAMP
Catalog Number100323C0
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerHOLGER ULLRICH
Manufacturer AddressMAQUET GMBH KEHLER STRASSE 31, RASTATT 76437 GM 76437


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-08-14

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