MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2020-02-19 for ULTRASAFE X100L PR PLUM SSL NVS STEIN 47513302 manufactured by Becton Dickinson.
| Report Number | 3001741852-2020-00019 |
| MDR Report Key | 9728401 |
| Report Source | CONSUMER,OTHER |
| Date Received | 2020-02-19 |
| Date of Report | 2020-02-21 |
| Date of Event | 2019-12-13 |
| Date Mfgr Received | 2020-01-30 |
| Date Added to Maude | 2020-02-19 |
| 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 | BDX BRETT WILKO |
| Manufacturer Street | 9450 SOUTH STATE STREET |
| Manufacturer City | SANDY UT 84070 |
| Manufacturer Country | US |
| Manufacturer Postal | 84070 |
| Manufacturer Phone | 8015652341 |
| Manufacturer G1 | BECTON DICKINSON |
| Manufacturer Street | FARADAY ROAD DORCAN |
| Manufacturer City | SWINDON WILTSHIRE SN3 5JH |
| Manufacturer Country | UK |
| Manufacturer Postal Code | SN3 5JH |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ULTRASAFE X100L PR PLUM SSL NVS STEIN |
| Generic Name | ULTRASAFE |
| Product Code | MEG |
| Date Received | 2020-02-19 |
| Catalog Number | 47513302 |
| Lot Number | SEE H.10 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECTON DICKINSON |
| Manufacturer Address | FARADAY ROAD DORCAN SWINDON WILTSHIRE SN3 5JH UK SN3 5JH |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-02-19 |