MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-11-13 for STELLANT DUAL CT INJECTOR 59879956 SCT DX manufactured by Bayer Medical Care Inc..
| Report Number | 2520313-2019-00053 |
| MDR Report Key | 9317423 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2019-11-13 |
| Date of Report | 2019-11-13 |
| Date of Event | 2019-10-19 |
| Date Mfgr Received | 2019-10-19 |
| Device Manufacturer Date | 2003-06-24 |
| Date Added to Maude | 2019-11-13 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | BIOMEDICAL ENGINEER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. LOIS MILLER |
| Manufacturer Street | ONE BAYER DRIVE |
| Manufacturer City | INDIANOLA PA 15051 |
| Manufacturer Country | US |
| Manufacturer Postal | 15051 |
| Manufacturer Phone | 7249407497 |
| Manufacturer G1 | BAYER MEDICAL CARE INC. |
| Manufacturer Street | ONE BAYER DRIVE |
| Manufacturer City | INDIANOLA PA 15051 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 15051 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | STELLANT DUAL CT INJECTOR |
| Generic Name | CT INJECTION SYSTEM |
| Product Code | DXT |
| Date Received | 2019-11-13 |
| Returned To Mfg | 2019-10-23 |
| Model Number | 59879956 |
| Catalog Number | SCT DX |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BAYER MEDICAL CARE INC. |
| Manufacturer Address | ONE BAYER DRIVE INDIANOLA PA 15051 US 15051 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-11-13 |