MINI STICK MAX H965457591

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2020-02-21 for MINI STICK MAX H965457591 manufactured by Angiodynamics.

MAUDE Entry Details

Report Number1317056-2020-00024
MDR Report Key9740543
Report SourceCOMPANY REPRESENTATIVE,CONSUM
Date Received2020-02-21
Date of Report2020-02-21
Date of Event2020-01-30
Date Mfgr Received2020-01-31
Device Manufacturer Date2019-12-27
Date Added to Maude2020-02-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactLAW RYAN
Manufacturer Street10 GLENS FALLS TECHNICAL PARK
Manufacturer CityGLENS FALLS, NY
Manufacturer CountryUS
Manufacturer Phone7424488
Manufacturer G1ANGIODYNAMICS
Manufacturer Street10 GLENS FALLS TECHNICAL PARK
Manufacturer CityGLENS FALLS, NY
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMINI STICK MAX
Generic NameVESSEL DILATOR FOR PERCUTANEOUS CATHETERIZATION
Product CodeDRE
Date Received2020-02-21
Catalog NumberH965457591
Lot Number5557204
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerANGIODYNAMICS
Manufacturer Address10 GLENS FALLS TECHNICAL PARK GLENS FALLS, NY US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-02-21

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