MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,foreign report with the FDA on 2019-11-15 for COL TB ZIG ZAG manufactured by ..
| Report Number | 3003205012-2019-00002 |
| MDR Report Key | 9326840 |
| Report Source | CONSUMER,FOREIGN |
| Date Received | 2019-11-15 |
| Date of Report | 2019-10-31 |
| Date Mfgr Received | 2019-10-31 |
| Date Added to Maude | 2019-11-15 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | DR. LEONARD HUMEL |
| Manufacturer Street | 909 RIVER ROAD |
| Manufacturer City | PISCATAWAY NJ 08854 |
| Manufacturer Country | US |
| Manufacturer Postal | 08854 |
| Manufacturer Phone | 7328787930 |
| Manufacturer G1 | COLGATE SANXIAO CO., LTD. |
| Manufacturer Street | NO.1 SANXIAO ROAD |
| Manufacturer City | YANGZHOU, 225111 |
| Manufacturer Country | CH |
| Manufacturer Postal Code | 225111 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | COL TB ZIG ZAG |
| Generic Name | COL TB ZIG ZAG |
| Product Code | EFW |
| Date Received | 2019-11-15 |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | . |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-11-15 |