MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-12 for VYAIRE VITAL SIGNS FACE MASK WITH ADJUSTABLE CUSHION R685OKS manufactured by Vyaire Medical, Inc..
| Report Number | MW5091019 |
| MDR Report Key | 9316072 |
| Date Received | 2019-11-12 |
| Date of Report | 2019-11-11 |
| Date of Event | 2019-10-31 |
| Date Added to Maude | 2019-11-13 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| 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 | 0 |
| Brand Name | VYAIRE VITAL SIGNS FACE MASK WITH ADJUSTABLE CUSHION |
| Generic Name | MASK, GAS, ANESTHETIC |
| Product Code | BSJ |
| Date Received | 2019-11-12 |
| Catalog Number | R685OKS |
| Lot Number | 1142911 |
| Device Expiration Date | 2019-05-23 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | VYAIRE MEDICAL, INC. |
| Manufacturer Address | METTAWA IL 60045 US 60045 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-11-12 |