MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-08-20 for FASCIABLASTER 89-IOS AT 21 manufactured by Adb Interests, Llc.
| Report Number | MW5089211 |
| MDR Report Key | 8915554 |
| Date Received | 2019-08-20 |
| Date of Report | 2019-08-17 |
| Date of Event | 2018-02-11 |
| Date Added to Maude | 2019-08-21 |
| 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 |
| Reporter Occupation | PATIENT |
| 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 | FASCIABLASTER |
| Generic Name | MASSAGER, THERAPEUTIC, MANUAL |
| Product Code | LYG |
| Date Received | 2019-08-20 |
| Model Number | 89-IOS AT 21 |
| Lot Number | CFR 8905350 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ADB INTERESTS, LLC |
| Brand Name | MINI BLASTER |
| Generic Name | MASSAGER, THERAPEUTIC, MANUAL |
| Product Code | LYG |
| Date Received | 2019-08-20 |
| Device Availability | * |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 2 |
| Device Event Key | 0 |
| Manufacturer | ADB INTERESTS, LLC |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Deathisabilit | 2019-08-20 |