DISP. 18X3, 1BLA, 1PRT, QUICK CONNECT 5921018135

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2019-11-13 for DISP. 18X3, 1BLA, 1PRT, QUICK CONNECT 5921018135 manufactured by Stryker Instruments-kalamazoo.

MAUDE Entry Details

Report Number0001811755-2019-03748
MDR Report Key9318942
Report SourceDISTRIBUTOR
Date Received2019-11-13
Date of Report2019-11-13
Date of Event2019-10-14
Date Mfgr Received2019-10-23
Date Added to Maude2019-11-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. ZACH BAKER
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDISP. 18X3, 1BLA, 1PRT, QUICK CONNECT
Generic NameTOURNIQUET, PNEUMATIC
Product CodeKCY
Date Received2019-11-13
Catalog Number5921018135
Lot Number60180373
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2019-11-13

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