MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-10-31 for EMA manufactured by Myerson Company Limited.
| Report Number | 3003928050-2019-00004 |
| MDR Report Key | 9260203 |
| Date Received | 2019-10-31 |
| Date of Report | 2019-06-28 |
| Date of Event | 2019-06-28 |
| Date Facility Aware | 2019-06-28 |
| Report Date | 2019-06-28 |
| Date Reported to Mfgr | 2019-06-28 |
| Date Added to Maude | 2019-10-31 |
| 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 | EMA |
| Generic Name | ELASTIC MANDIBULAR ADVANCEMENT APPLIANCE |
| Product Code | LRK |
| Date Received | 2019-10-31 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MYERSON COMPANY LIMITED |
| Manufacturer Address | 3 TRINITY AVENUE LAVENTILLE, 00000 TD 00000 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-10-31 |