MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-01-17 for RELI BFN18G101 manufactured by Micsafe Medical Group (china) Co. Inc..
| Report Number | 1058382-2020-00001 |
| MDR Report Key | 9603314 |
| Date Received | 2020-01-17 |
| Date of Report | 2020-01-13 |
| Date of Event | 2020-01-07 |
| Report Date | 2020-01-13 |
| Date Reported to FDA | 2020-01-13 |
| Date Reported to Mfgr | 2020-01-08 |
| Date Added to Maude | 2020-01-17 |
| Event Key | 0 |
| Report Source Code | Distributor report |
| Manufacturer Link | N |
| 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 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | RELI |
| Generic Name | BLUNT FILL NEEDLE |
| Product Code | GAA |
| Date Received | 2020-01-17 |
| Catalog Number | BFN18G101 |
| Lot Number | 190530 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | 6 MO |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MICSAFE MEDICAL GROUP (CHINA) CO. INC. |
| Manufacturer Address | 802-805, BUILDING 6 NO.1678 JINGSHAJIANG RD. SHANGHAI, 200333 CH 200333 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-01-17 |