VIZISHOT SINGLE USE INSPIRATION NEEDLE NA-201SX-4021

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-18 for VIZISHOT SINGLE USE INSPIRATION NEEDLE NA-201SX-4021 manufactured by Olympus Medical Systems, Corp..

MAUDE Entry Details

Report NumberMW5090475
MDR Report Key9213627
Date Received2019-10-18
Date of Report2019-10-17
Date of Event2019-10-07
Date Added to Maude2019-10-21
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVIZISHOT SINGLE USE INSPIRATION NEEDLE
Generic NameBRONCHOSCOPE ACCESSORY
Product CodeKTI
Date Received2019-10-18
Catalog NumberNA-201SX-4021
Lot Number91V
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerOLYMPUS MEDICAL SYSTEMS, CORP.
Manufacturer AddressISHIKAWA-CHO HACHIOJI-SHI 192-8507 JA 192-8507


Patients

Patient NumberTreatmentOutcomeDate
10 2019-10-18

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