MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-21 for FILSHIE TUBAL LIGATION SYSTEM AVM-851 manufactured by Coopersurgical.
| Report Number | MW5090551 |
| MDR Report Key | 9219980 |
| Date Received | 2019-10-21 |
| Date of Report | 2019-10-18 |
| Date of Event | 2019-10-16 |
| Date Added to Maude | 2019-10-22 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | FILSHIE TUBAL LIGATION SYSTEM |
| Generic Name | FILSHIE CLIPS |
| Product Code | KNH |
| Date Received | 2019-10-21 |
| Catalog Number | AVM-851 |
| Lot Number | 35041 |
| Device Expiration Date | 2017-09-30 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COOPERSURGICAL |
| Manufacturer Address | US |
| Brand Name | FILSHIE TUBAL LIGATION SYSTEM |
| Generic Name | FILSHIE CLIPS |
| Product Code | KNH |
| Date Received | 2019-10-21 |
| Catalog Number | AVM-851 |
| Lot Number | 35041 |
| Device Expiration Date | 2017-09-30 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 2 |
| Device Event Key | 0 |
| Manufacturer | COOPERSURGICAL |
| Manufacturer Address | US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-10-21 |