FDA.reportPublic FDA data

MAUDE MDR 9634510

MDR report key
9634510
Report number
9610617-2020-00010
Event key
0
Event type
3
Date of event
2020-01-17
Date received
2020-01-27
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
MRS. SUSIE CHEN
Address
2151 E. GRAND AVENUE EL SEGUNDO CA 90245 US
Phone
424-424-4242
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ROUND KNIFE 45?, ? 2 MM, 16 CMROUND KNIFEKARL STORZ SE & CO. KGLRC226820226820TS01Y Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-01-2701. R

Event Narratives#

No narrative records found.