MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2019-09-05 for ICS CHARTR 200 ENG/VNG 8-04-11945 manufactured by Natus Medical Denmark (gn Otometrics).
| Report Number | 9612197-2019-00016 |
| MDR Report Key | 8963847 |
| Report Source | DISTRIBUTOR |
| Date Received | 2019-09-05 |
| Date of Report | 2019-11-28 |
| Date of Event | 2019-05-24 |
| Date Mfgr Received | 2019-07-11 |
| Device Manufacturer Date | 2018-09-21 |
| Date Added to Maude | 2019-09-05 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| 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 |
| Manufacturer Contact | MISS LOUISE CALLANAN |
| Manufacturer Street | IDA BUSINESS PARK GORT |
| Manufacturer City | GALWAY, CONNAUGHT H91PD92 |
| Manufacturer Country | EI |
| Manufacturer Postal | H91PD92 |
| Manufacturer G1 | NATUS MEDICAL DENMARK (GN OTOMETRICS) |
| Manufacturer Street | HOERSKAETTEN 9, |
| Manufacturer City | TAASTRUP, 2630 |
| Manufacturer Country | DA |
| Manufacturer Postal Code | 2630 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ICS CHARTR 200 ENG/VNG |
| Generic Name | ICS CHARTR 200 ENG/VNG |
| Product Code | GWN |
| Date Received | 2019-09-05 |
| Returned To Mfg | 2019-10-24 |
| Model Number | 8-04-11945 |
| Catalog Number | 8-04-11945 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | NATUS MEDICAL DENMARK (GN OTOMETRICS) |
| Manufacturer Address | HOERSKAETTEN 9, TAASTRUP, 2630 DA 2630 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-09-05 |