FDA.reportPublic FDA data

MAUDE MDR 9391998

MDR report key
9391998
Report number
2937457-2019-03492
Event key
0
Event type
3
Date of event
2019-11-11
Date received
2019-11-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
3
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MATTHEW AMARAL
Address
920 WINTER ST WALTHAM MA 02451 US
Phone
781-781-7816
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1LIBERTY SELECT CYCLER ASSY(NON-VALUATED)SYSTEM, PERITONEAL, AUTOMATIC DELIVERYCONCORD MANUFACTURINGFKXRTLR180343R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-11-2901. H; 2. R

Event Narratives#

No narrative records found.