FDA.reportPublic FDA data

MAUDE MDR 8896702

MDR report key
8896702
Report number
1417592-2019-00134
Event key
0
Event type
3
Date of event
2019-07-18
Date received
2019-08-15
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
3
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
BERMON PUNZALAN
Address
THREE LAKES DRIVE NORTHFIELD IL 60093 US
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1AIR SHEET,LATERAL,COMFORT GLIDE,40X80MEDLINE INDUSTRIES INC.FMRMSC600LTUNKR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-08-1501. O; 2. R

Event Narratives#

No narrative records found.