FDA.reportPublic FDA data

MAUDE MDR 9177434

MDR report key
9177434
Report number
8020889-2019-00142
Event key
0
Event type
3
Date of event
2019-09-20
Date received
2019-10-10
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
AVI KLUGER
Address
5920 LONGBOW DRIVE BOULDER CO 80301 US
Phone
303-303-3035
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1SHILEYTUBE, BRONCHIAL (W/WO CONNECTOR)MALLINCKRODT MEDICALBTS126-37126-37201610503X* N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-100

Event Narratives#

No narrative records found.