MEDICAL GRADE ISOLATION UPS 015626 UPS-NA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2019-10-30 for MEDICAL GRADE ISOLATION UPS 015626 UPS-NA manufactured by Natus Medical Inc. Dba Excel-tech Ltd (xltek).

MAUDE Entry Details

Report Number9612330-2019-00008
MDR Report Key9255161
Report SourceHEALTH PROFESSIONAL
Date Received2019-10-30
Date of Report2019-09-30
Date of Event2019-09-30
Date Mfgr Received2019-09-30
Date Added to Maude2019-10-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. SANJAY MEHTA
Manufacturer Street2568 BRISTOL CIRCLE
Manufacturer CityONTARIO L6H 5S1
Manufacturer CountryCA
Manufacturer PostalL6H 5S1
Manufacturer G1NATUS MEDICAL INCORPORATED DBA EXCEL-TECH
Manufacturer Street2568 BRISTOL CIRCLE
Manufacturer CityOAKVILLE, L6H5S1
Manufacturer CountryCA
Manufacturer Postal CodeL6H5S1
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMEDICAL GRADE ISOLATION UPS
Generic NameELECTROENCEPHALOGRAPH ACCESSORY
Product CodeGWQ
Date Received2019-10-30
Returned To Mfg2019-11-14
Model Number015626
Catalog NumberUPS-NA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerNATUS MEDICAL INC. DBA EXCEL-TECH LTD (XLTEK)
Manufacturer Address2568 BRISTOL CIRCLE OAKVILLE, L6H 5S1 CA L6H 5S1


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-10-30

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