MAUDE MDR 9265414

MDR report key
9265414
Report number
8010047-2019-03794
Event key
0
Event type
3
Date received
2019-11-01
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR KAZUTAKA MATSUMOTO
Address
2951 ISHIKAWA-CHO HACHIOJI-SHI, TOKYO-TO 192-8 JA
Phone
426-426-4264
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CAMERA HEADCAMERA HEADOLYMPUS MEDICAL SYSTEMS CORP.FETOTV-S7H-1D-L08EN N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-11-010

Event Narratives#

No narrative records found.