MAUDE MDR 9293336

MDR report key
9293336
Report number
9611959-2019-00001
Event key
0
Event type
3
Date of event
2019-09-11
Date received
2019-11-07
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
MS MAY KANSOU
Address
CA
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1PATTERSON SALIVA EJECTORSSALIVA EJECTORPATTERSON DENTAL SUPPLY, INC.DYN107-3980R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-11-070

Event Narratives#

No narrative records found.