MAUDE MDR 9191010

MDR report key
9191010
Report number
1018233-2019-06458
Event key
0
Event type
3
Date received
2019-10-15
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
3
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
YONIC ANDERSON
Address
8195 INDUSTRIAL BLVD COVINGTON GA 30014 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1SL FOLEY SWIVEL SILICONE TRICOT 25BXSTATLOCKC.R. BARD, INC. (COVINGTON) -1018233EYJFOL0102UNKR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-150

Event Narratives#

No narrative records found.