MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2020-02-28 for INOMAX DSIR (DELIVERY SYSTEM) 10071 manufactured by Mallinckrodt Manufacturing Llc.
| Report Number | 3004531588-2020-00021 |
| MDR Report Key | 9771880 |
| Report Source | COMPANY REPRESENTATIVE,DISTRI |
| Date Received | 2020-02-28 |
| Date of Report | 2020-02-28 |
| Date of Event | 2019-02-09 |
| Date Mfgr Received | 2020-01-31 |
| Device Manufacturer Date | 2016-05-05 |
| Date Added to Maude | 2020-02-28 |
| 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 | MEGAN VERNAK |
| Manufacturer Street | 1425 US ROUTE 206 |
| Manufacturer City | BEDMINSTER, NJ |
| Manufacturer Country | US |
| Manufacturer G1 | MALLINCKRODT MANUFACTURING LLC |
| Manufacturer Street | 6603 FEMRITE DRIVE |
| Manufacturer City | MADISON, WI |
| Manufacturer Country | US |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | INOMAX DSIR (DELIVERY SYSTEM) |
| Generic Name | APPARATUS |
| Product Code | MRN |
| Date Received | 2020-02-28 |
| Model Number | 10071 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MALLINCKRODT MANUFACTURING LLC |
| Manufacturer Address | 6603 FEMRITE DRIVE MADISON, WI US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-02-28 |