FDA.reportPublic FDA data

MAUDE MDR 9234525

MDR report key
9234525
Report number
3006260740-2019-03326
Event key
0
Event type
3
Date of event
2019-10-02
Date received
2019-10-24
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
KELSEY ERICKSON
Address
605 N. 5600 W. SALT LAKE CITY UT 84116 US
Phone
801-801-8015
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1POWER MIDLINE CATHETER 4F SLCATHETER,INTRAVASCULAR,THERAPEUTIC, LONG-TERM GREATER THAN 30 DAYSBARD ACCESS SYSTEMSPNDN/ACK000523BREDS1161Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-240

Event Narratives#

No narrative records found.