MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-25 for DRIVE UNKNOWN manufactured by Unknown.
Report Number | 2438477-2019-00071 |
MDR Report Key | 9241379 |
Date Received | 2019-10-25 |
Date of Report | 2019-10-25 |
Date of Event | 2019-09-19 |
Date Facility Aware | 2019-09-19 |
Report Date | 2019-10-25 |
Date Reported to FDA | 2019-10-25 |
Date Added to Maude | 2019-10-25 |
Event Key | 0 |
Report Source Code | Distributor report |
Manufacturer Link | N |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
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 | 3 |
Brand Name | DRIVE |
Generic Name | ROLLATOR |
Product Code | ITJ |
Date Received | 2019-10-25 |
Model Number | UNKNOWN |
Operator | LAY USER/PATIENT |
Device Availability | N |
Device Eval'ed by Mfgr | * |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | UNKNOWN |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Congenital Not Applicablenomaly; 2. Hospitalization | 2019-10-25 |