MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-01 for ACIST CVI ANGIOGRAPHIC INJECTION SYSTEM manufactured by Acist Medical Systems, Inc..
| Report Number | 9139299 |
| MDR Report Key | 9139299 |
| Date Received | 2019-10-01 |
| Date of Report | 2019-09-23 |
| Date of Event | 2019-08-05 |
| Report Date | 2019-09-23 |
| Date Reported to FDA | 2019-09-23 |
| Date Reported to Mfgr | 2019-10-01 |
| Date Added to Maude | 2019-10-01 |
| 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 | ACIST CVI ANGIOGRAPHIC INJECTION SYSTEM |
| Generic Name | INJECTOR AND SYRINGE, ANGIOGRAPHIC |
| Product Code | DXT |
| Date Received | 2019-10-01 |
| Device Availability | N |
| Device Age | 4 YR |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ACIST MEDICAL SYSTEMS, INC. |
| Manufacturer Address | 7905 FULLER ROAD EDEN PRAIRIE MN 55344 US 55344 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2019-10-01 |