FDA.reportPublic FDA data

MAUDE MDR 9391927

MDR report key
9391927
Report number
3012307300-2019-06693
Event key
0
Event type
3
Date of event
2019-10-31
Date received
2019-11-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
DAVE HALVERSON
Address
6000 LANE N MINNEAPOLIS MN 55442 US
Phone
763-763-7633
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CADD ADMINISTRATION SETSET, ADMINISTRATION, INTRAVASCULARINFUSYSTEM INCFPACADD ADMINISTRATION SETS21-7394-243808534R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-11-290

Event Narratives#

No narrative records found.