FDA.reportPublic FDA data

MAUDE MDR 8907053

MDR report key
8907053
Report number
3010377594-2019-00006
Event key
0
Event type
3
Date of event
2019-07-30
Date received
2019-08-19
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. DEBORAH PACHECO
Address
331 S. 104TH ST. SUITE 200 LOUISVILLE CO 80027 US
Phone
720-720-7202
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1JUSTRIGHT 5MM STAPLERMANUAL SURGICAL INSTRUMENT FOR GENERAL USEJUSTRIGHT SURGICALGAGJR-ST25-2.0-6JR-ST25-2.0-675DI0251R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-08-190

Event Narratives#

No narrative records found.