MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-01-08 for 5.5 EXP VERSE FEN SCR 6.0X35 199723635 manufactured by Medos International Sàrl Ch.
Report Number | 1526439-2020-00282 |
MDR Report Key | 9565222 |
Report Source | COMPANY REPRESENTATIVE,FOREIG |
Date Received | 2020-01-08 |
Date of Report | 2019-11-29 |
Date Mfgr Received | 2020-01-31 |
Device Manufacturer Date | 2018-11-13 |
Date Added to Maude | 2020-01-08 |
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 Contact | KARA DITTY-BOVARD |
Manufacturer Street | 325 PARAMOUNT DRIVE |
Manufacturer City | RAYNHAM MA 02767 |
Manufacturer Country | US |
Manufacturer Postal | 02767 |
Manufacturer Phone | 6103142063 |
Manufacturer G1 | BRIDGEWATER DISTRIBUTION |
Manufacturer Street | 50 SCOTLAND BOULEVARD |
Manufacturer City | BRIDGEWATER MA 02324 |
Manufacturer Country | US |
Manufacturer Postal Code | 02324 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | 5.5 EXP VERSE FEN SCR 6.0X35 |
Generic Name | BONE CEMENT, POSTERIOR SCREW AUGMENTATION |
Product Code | PML |
Date Received | 2020-01-08 |
Returned To Mfg | 2020-01-15 |
Model Number | 199723635 |
Catalog Number | 199723635 |
Lot Number | 221029 |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | MEDOS INTERNATIONAL SàRL CH |
Manufacturer Address | CHEMIN-BLANC 38 LE LOCLE 02400 SZ 02400 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 2020-01-08 |