FILSHIE CLIPS AVM 851 LOG 389414

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-18 for FILSHIE CLIPS AVM 851 LOG 389414 manufactured by Cooper Surgical, Inc..

MAUDE Entry Details

Report NumberMW5091158
MDR Report Key9341466
Date Received2019-11-18
Date of Report2019-11-14
Date of Event2015-06-12
Date Added to Maude2019-11-19
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameFILSHIE CLIPS AVM 851
Generic NameLAPAROSCOPIC CONTRACEPTIVE TUBAL OCCLUSION DEVICE
Product CodeKNH
Date Received2019-11-18
Model NumberLOG 389414
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerCOOPER SURGICAL, INC.


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention; 2. Deathisabilit 2019-11-18

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