MAUDE MDR 9147857

MDR report key
9147857
Report number
1221359-2019-00066
Event key
0
Event type
3
Date of event
2019-09-08
Date received
2019-10-02
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
BENJAMIN CRYSTAL
Address
10 SOUTHGATE RD SCARBOROUGH ME 04074 US
Phone
207-207-2077
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ALERE DETERMINE HIV-1/2 AG/AB COMBOIVD FOR HIV 1/2 AG/ABABBOTT DIAGNOSTICS SCARBOROUGHMZF7D2648110834N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-020

Event Narratives#

No narrative records found.