SENSOR M0066703081 670-308

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-10-01 for SENSOR M0066703081 670-308 manufactured by Boston Scientific Corporation.

MAUDE Entry Details

Report Number3005099803-2019-04780
MDR Report Key9142330
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-10-01
Date of Report2019-11-04
Date of Event2019-09-03
Date Mfgr Received2019-10-14
Device Manufacturer Date2019-07-03
Date Added to Maude2019-10-01
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 ContactCAROLE MORLEY
Manufacturer Street300 BOSTON SCIENTIFIC WAY
Manufacturer CityMARLBOROUGH MA 01752
Manufacturer CountryUS
Manufacturer Postal01752
Manufacturer Phone5086834015
Manufacturer G1BOSTON SCIENTIFIC CORPORATION
Manufacturer Street2546 CALLE PRIMERA PROPARK, COYOL,
Manufacturer CityALAJUELA
Manufacturer CountryCS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSENSOR
Generic NameSTYLET FOR CATHETER, GASTRO-UROLOGY
Product CodeEZB
Date Received2019-10-01
Returned To Mfg2019-09-23
Model NumberM0066703081
Catalog Number670-308
Lot Number0024056240
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerBOSTON SCIENTIFIC CORPORATION
Manufacturer Address300 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US 01752


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2019-10-01

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