STEALTH? SPRING CLIP A1603

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-04 for STEALTH? SPRING CLIP A1603 manufactured by Applied Medical Resources Corporation.

MAUDE Entry Details

Report Number9271446
MDR Report Key9271446
Date Received2019-11-04
Date of Report2019-10-23
Date of Event2019-10-13
Report Date2019-10-23
Date Reported to FDA2019-10-23
Date Reported to Mfgr2019-11-04
Date Added to Maude2019-11-04
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSTEALTH? SPRING CLIP
Generic NameCLIP, VASCULAR
Product CodeDSS
Date Received2019-11-04
Model NumberA1603
Catalog NumberA1603
Lot Number1357103
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerAPPLIED MEDICAL RESOURCES CORPORATION
Manufacturer Address22872 AVENIDA EMPRESA RANCHO SANTA MARGARITA CA 92688 US 92688


Patients

Patient NumberTreatmentOutcomeDate
10 2019-11-04

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