MAUDE MDR 9253869

MDR report key
9253869
Report number
2647580-2019-05414
Event key
0
Event type
3
Date of event
2019-10-02
Date received
2019-10-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
LISA HERNANDEZ
Address
60 MIDDLETOWN AVE. NORTH HAVEN CT 06473 US
Phone
203-203-2034
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ENDO CLINCH IIFORCEPS, OBSTETRICALUS SURGICAL PUERTO RICOHDA174317174317P9A0725Y* N

Patients#

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

Event Narratives#

No narrative records found.