UROPASS AS 10/12FR X 54 CM 5/BX 61054BX

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,other, report with the FDA on 2020-01-02 for UROPASS AS 10/12FR X 54 CM 5/BX 61054BX manufactured by Teleflex Medical Oem.

MAUDE Entry Details

Report Number2951238-2020-00294
MDR Report Key9539765
Report SourceCOMPANY REPRESENTATIVE,OTHER,
Date Received2020-01-02
Date of Report2020-02-27
Date of Event2019-12-05
Date Mfgr Received2020-02-04
Date Added to Maude2020-01-02
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. CONNIE TUBERA
Manufacturer Street2400 RINGWOOD AVENUE
Manufacturer CitySAN JOSE CA 95131
Manufacturer CountryUS
Manufacturer Postal95131
Manufacturer Phone4089355124
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUROPASS AS 10/12FR X 54 CM 5/BX
Generic NameUROPASS AS 10/12FR X 54
Product CodeKNH
Date Received2020-01-02
Model Number61054BX
Lot Number09M1700013
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX MEDICAL OEM
Manufacturer Address3750 ANNAPOLIS LANE NORTH, SUITE 160 PLYMOUTH MN 55447 US 55447


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-02

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