HARD LINER CHAIRSIDE RELINE MATERIAL

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-01 for HARD LINER CHAIRSIDE RELINE MATERIAL manufactured by Unk.

MAUDE Entry Details

Report NumberMW5090186
MDR Report Key9147129
Date Received2019-10-01
Date of Report2019-09-30
Date of Event2019-09-09
Date Added to Maude2019-10-02
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHARD LINER CHAIRSIDE RELINE MATERIAL
Generic NameRESIN, DENTURE, RELINING, REPARING, REBASING
Product CodeEBI
Date Received2019-10-01
Returned To Mfg2019-09-13
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerUNK
Manufacturer AddressUNK UNK


Patients

Patient NumberTreatmentOutcomeDate
10 2019-10-01

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