FDA.reportPublic FDA data

MAUDE MDR 9668996

MDR report key
9668996
Report number
1047429-2020-00001
Event key
0
Event type
3
Date of event
2020-01-06
Date received
2020-02-04
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. NICHOLE EARLY
Address
9000 WESTMONT DR. STONEHOUSE COMMERCE PARK TOANO VA 23168 US
Phone
828-828-8283
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1FINE SURGICALHEMOSTATCROWN SURGICAL CORP.HRQ12-201P729028N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-02-040

Event Narratives#

No narrative records found.