MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign report with the FDA on 2019-09-10 for 804018 manufactured by Isotis Orthobiologics, Inc.
| Report Number | 2090010-2019-00006 |
| MDR Report Key | 8984780 |
| Report Source | FOREIGN |
| Date Received | 2019-09-10 |
| Date of Report | 2019-09-10 |
| Date of Event | 2018-09-27 |
| Date Mfgr Received | 2019-08-28 |
| Date Added to Maude | 2019-09-10 |
| 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 | MR. AARON |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Generic Name | CEMENT OBTURATOR |
| Product Code | LZN |
| Date Received | 2019-09-10 |
| Model Number | 804018 |
| Lot Number | 112.76 |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ISOTIS ORTHOBIOLOGICS, INC |
| Manufacturer Address | 2 GOODYEAR |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other; 2. Required No Informationntervention | 2019-09-10 |