MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-26 for CLEANFREAK DUAL ENDED CLEANING BRUSH 1200.04 manufactured by Medovations / Diversatek Healthcare Inc..
| Report Number | MW5091319 |
| MDR Report Key | 9383522 |
| Date Received | 2019-11-26 |
| Date of Report | 2019-11-21 |
| Date of Event | 2019-11-13 |
| Date Added to Maude | 2019-11-27 |
| 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 |
| 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 | CLEANFREAK DUAL ENDED CLEANING BRUSH |
| Generic Name | ACCESSORIES, CLEANING BRUSHES, FOR ENDOSCOPE |
| Product Code | MNL |
| Date Received | 2019-11-26 |
| Model Number | 1200.04 |
| Lot Number | 001892 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDOVATIONS / DIVERSATEK HEALTHCARE INC. |
| Manufacturer Address | 102 E. KEEFE AVE MILWAUKEE WI 53212 US 53212 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-11-26 |