FDA.reportPublic FDA data

MAUDE MDR 8964836

MDR report key
8964836
Report number
1319558-2019-00006
Event key
0
Event type
3
Date of event
2019-08-11
Date received
2019-09-05
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. TRAVIS SCOTT
Address
103 WOODCREST DRIVE RIFTON NY 12471 US
Phone
845-845-8456
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1RIFTON ACTIVITY CHAIRACTIVITY CHAIRRIFTON EQUIPMENTINNR860R860R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-09-050

Event Narratives#

No narrative records found.