MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-01-02 for TUBING SETS HQV 98701#PEDIATRIC SET 70106.3467 manufactured by Maquet Cardiopulmonary Gmbh.
| Report Number | 8010762-2019-00399 | 
| MDR Report Key | 9537391 | 
| Report Source | COMPANY REPRESENTATIVE,HEALTH | 
| Date Received | 2020-01-02 | 
| Date of Report | 2020-03-20 | 
| Date of Event | 2019-11-13 | 
| Date Mfgr Received | 2020-03-19 | 
| Device Manufacturer Date | 2019-01-05 | 
| Date Added to Maude | 2020-01-02 | 
| 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 | 
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL | 
| Health Professional | 3 | 
| Initial Report to FDA | 3 | 
| Report to FDA | 3 | 
| Event Location | 3 | 
| Manufacturer Street | MAQUET CARDIOPULMONARY AG KEHLER STRASSE 31 | 
| Manufacturer City | RASTATT 76437 | 
| Manufacturer Country | GM | 
| Manufacturer Postal | 76437 | 
| Manufacturer Phone | 4972229321 | 
| Manufacturer G1 | NURSEL BOELENS | 
| Manufacturer Street | MAQUET CARDIOPULMONARY AG KEHLER STRASSE 31 | 
| Manufacturer City | RASTATT 76437 | 
| Manufacturer Country | GM | 
| Manufacturer Postal Code | 76437 | 
| Single Use | 3 | 
| Previous Use Code | 3 | 
| Event Type | 3 | 
| Type of Report | 3 | 
| Brand Name | TUBING SETS | 
| Generic Name | TUBING, PUMP, CARDIOPULMONARY BYPASS | 
| Product Code | DWE | 
| Date Received | 2020-01-02 | 
| Model Number | HQV 98701#PEDIATRIC SET | 
| Catalog Number | 70106.3467 | 
| Lot Number | 70123799 | 
| Operator | HEALTH PROFESSIONAL | 
| Device Availability | * | 
| Device Age | DA | 
| Device Eval'ed by Mfgr | Y | 
| Device Sequence No | 1 | 
| Device Event Key | 0 | 
| Manufacturer | MAQUET CARDIOPULMONARY GMBH | 
| Manufacturer Address | NEUE ROTTENBURGER STRASSE 37 HECHINGEN US | 
| Patient Number | Treatment | Outcome | Date | 
|---|---|---|---|
| 1 | 0 | 2020-01-02 |