SHEATH - INNER W/CERAMIC INSULATE R27040X4

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-02 for SHEATH - INNER W/CERAMIC INSULATE R27040X4 manufactured by Karl Storz Endoscopy - America Inc..

MAUDE Entry Details

Report NumberMW5090188
MDR Report Key9150906
Date Received2019-10-02
Date of Report2019-09-25
Date of Event2019-07-12
Date Added to Maude2019-10-03
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag0
Reprocessed and Reused Flag3
Reporter OccupationUNKNOWN
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameSHEATH - INNER W/CERAMIC INSULATE
Generic NameRESECTOSCOPE - URETER
Product CodeFJL
Date Received2019-10-02
Model NumberR27040X4
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerKARL STORZ ENDOSCOPY - AMERICA INC.


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-10-02

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