FDA.reportPublic FDA data

MAUDE MDR 9253177

MDR report key
9253177
Report number
3003775027-2019-00173
Event key
0
Event type
3
Date of event
2019-10-10
Date received
2019-10-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
YUKAKO HOMMA
Address
3-100 AKATSUKI-CHO SETO, AICHI 489-0 JA
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ASAHI CHIKAI 008NEUROVASCULAR GUIDE WIREASAHI INTECC CO., LTD.MOFNAWAIN-CKI-008-200190417A18AR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-10-290

Event Narratives#

No narrative records found.