MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-08-30 for MEDLINE INDUSTRIES CAROTID FISTULA PROCEDURE PACK DYNJ53787A manufactured by Medline Industries, Inc..
| Report Number | MW5089499 |
| MDR Report Key | 8955815 |
| Date Received | 2019-08-30 |
| Date of Report | 2019-08-20 |
| Date of Event | 2019-08-19 |
| Date Added to Maude | 2019-09-03 |
| 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 | MEDLINE INDUSTRIES CAROTID FISTULA PROCEDURE PACK |
| Generic Name | CARDIAC CATHETERIZATION KIT |
| Product Code | OES |
| Date Received | 2019-08-30 |
| Catalog Number | DYNJ53787A |
| Lot Number | 19EDA641 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES, INC. |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-08-30 |