MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-01-27 for PRIME TC SWING-AWAY MODEL 1460000000 manufactured by Stryker Medical-kalamazoo.
[176834902]
This mdr is a consolidation of records summarized as part of the fda voluntary malfunction summary reporting program. The devices were evaluated in the field and the issue was confirmed; there were three devices with broken/damaged components and one device with loose components. The devices were repaired and returned. There was no remedial action taken. This device is not labeled for single use.
Patient Sequence No: 1, Text Type: N, H10
[176834903]
This report summarizes
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001831750-2020-00118 |
| MDR Report Key | 9634017 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2020-01-27 |
| Date of Report | 2020-01-27 |
| Date of Event | 2020-01-01 |
| Date Mfgr Received | 2020-01-01 |
| Date Added to Maude | 2020-01-27 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. KRISTEN CANTER |
| Manufacturer Street | 3800 EAST CENTRE AVENUE |
| Manufacturer City | PORTAGE MI 49002 |
| Manufacturer Country | US |
| Manufacturer Postal | 49002 |
| Manufacturer Phone | 2693292100 |
| Manufacturer G1 | STRYKER MEDICAL-KALAMAZOO |
| Manufacturer Street | 3800 EAST CENTRE AVENUE |
| Manufacturer City | PORTAGE MI 49002 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 49002 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PRIME TC SWING-AWAY MODEL |
| Generic Name | CHAIR, ADJUSTABLE, MECHANICAL |
| Product Code | INN |
| Date Received | 2020-01-27 |
| Catalog Number | 1460000000 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STRYKER MEDICAL-KALAMAZOO |
| Manufacturer Address | 3800 EAST CENTRE AVENUE PORTAGE MI 49002 US 49002 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-01-27 |