FOREIGN BODY RETRIEVAL HOOD PROTECTOR 69392 109281002

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-09-20 for FOREIGN BODY RETRIEVAL HOOD PROTECTOR 69392 109281002 manufactured by Avanos Medical Inc..

MAUDE Entry Details

Report Number8030647-2019-00089
MDR Report Key9098095
Date Received2019-09-20
Date of Report2019-09-20
Date of Event2019-08-30
Date Mfgr Received2019-08-30
Date Added to Maude2019-09-20
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LISA CLARK
Manufacturer Street5405 WINDWARD PARKWAY
Manufacturer CityALPHARETTA GA 30004
Manufacturer CountryUS
Manufacturer Postal30004
Manufacturer Phone4704485444
Manufacturer G1AVENT S DE RL DE CV
Manufacturer StreetCARRETERA INTERNACIONAL SALIDA NORTE NO. 1053
Manufacturer CityMAGDALENA, CP 84160
Manufacturer CountryMX
Manufacturer Postal Code84160
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameFOREIGN BODY RETRIEVAL HOOD PROTECTOR
Generic NameDH ENDOSCOPY GRASPING & RETRIEVING DEVICES
Product CodeFED
Date Received2019-09-20
Model Number69392
Catalog Number109281002
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerAVANOS MEDICAL INC.
Manufacturer Address5405 WINDWARD PARKWAY ALPHARETTA GA 30004 US 30004


Patients

Patient NumberTreatmentOutcomeDate
10 2019-09-20

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