MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other report with the FDA on 2019-10-03 for VASERLIPO SYSTEM manufactured by Solta Medical.
Report Number | 3011423170-2019-00101 |
MDR Report Key | 9153484 |
Report Source | OTHER |
Date Received | 2019-10-03 |
Date of Report | 2019-09-11 |
Date of Event | 2017-10-03 |
Report Date | 2005-01-01 |
Date Reported to FDA | 2005-01-01 |
Date Reported to Mfgr | 2005-01-10 |
Date Mfgr Received | 2019-09-11 |
Date Added to Maude | 2019-10-03 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MS. JULI MOORE |
Manufacturer Street | 3365 TREE COURT INDUSTRIAL BLV |
Manufacturer City | ST. LOUIS MO 63122 |
Manufacturer Country | US |
Manufacturer Postal | 63122 |
Manufacturer Phone | 6362263220 |
Manufacturer G1 | SOLTA MEDICAL |
Manufacturer Street | 11720 N CREEK PARKWAY N STE 100 |
Manufacturer City | BOTHELL WA 98011 |
Manufacturer Country | US |
Manufacturer Postal Code | 98011 |
Single Use | 0 |
Previous Use Code | 0 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | VASERLIPO SYSTEM |
Generic Name | SYSTEM, SUCTION, LIPOPLASTY |
Product Code | MUU |
Date Received | 2019-10-03 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | SOLTA MEDICAL |
Manufacturer Address | BOTHELL WA 98011 US 98011 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2019-10-03 |