SUCTION CANISTER OR1910PG

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-01 for SUCTION CANISTER OR1910PG manufactured by Medline Industries, Inc..

MAUDE Entry Details

Report Number9266299
MDR Report Key9266299
Date Received2019-11-01
Date of Report2019-10-03
Date of Event2019-09-15
Report Date2019-10-04
Date Reported to FDA2019-10-04
Date Reported to Mfgr2019-11-01
Date Added to Maude2019-11-01
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSUCTION CANISTER
Generic NameBOTTLE, COLLECTION, VACUUM
Product CodeKDQ
Date Received2019-11-01
Model NumberOR1910PG
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDLINE INDUSTRIES, INC.
Manufacturer AddressTHREE LAKES DRIVE NORTHFIELD IL 60093 US 60093


Patients

Patient NumberTreatmentOutcomeDate
10 2019-11-01

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