MAUDE MDR 9547693

MDR report key
9547693
Report number
1417592-2019-00232
Event key
0
Event type
3
Date of event
2019-11-05
Date received
2020-01-03
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
NIGEL VILCHES
Address
THREE LAKES DRIVE NORTHFIELD, IL IL 60093 US
Phone
224-224-2249
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1UNDERWEAR,PROTECTIVE,ULTRA,LG,40-56"MEDLINE INDUSTRIES INC.EYQFIT23505AR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-01-0301. H

Event Narratives#

No narrative records found.