MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-09-06 for 2000ML RECEPTAL? LINER WITH VAC-GARD? 1 430420411 manufactured by Amsino International, Inc..
| Report Number | 8968942 |
| MDR Report Key | 8968942 |
| Date Received | 2019-09-06 |
| Date of Report | 2019-07-03 |
| Date of Event | 2019-06-26 |
| Report Date | 2019-07-03 |
| Date Reported to FDA | 2019-07-03 |
| Date Reported to Mfgr | 2019-09-06 |
| Date Added to Maude | 2019-09-06 |
| Event Key | 0 |
| Report Source Code | User Facility 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 | RISK MANAGER |
| 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 | 3 |
| Brand Name | 2000ML RECEPTAL? LINER WITH VAC-GARD? |
| Generic Name | APPARATUS, SUCTION, OPERATING-ROOM, WALL VACUUM POWERED |
| Product Code | GCX |
| Date Received | 2019-09-06 |
| Model Number | 1 |
| Catalog Number | 430420411 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AMSINO INTERNATIONAL, INC. |
| Manufacturer Address | 708 CORPORATE CENTER DR. POMONA CA 91768 US 91768 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-09-06 |