LUTONIX 035 DRUG COATED BALLOON PTA CATHETER 9004 LX3513051205F

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-09 for LUTONIX 035 DRUG COATED BALLOON PTA CATHETER 9004 LX3513051205F manufactured by Lutonix, Inc.

MAUDE Entry Details

Report Number3006513822-2020-00004
MDR Report Key9808967
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-09
Date of Report2020-03-09
Date Mfgr Received2020-02-11
Device Manufacturer Date2019-02-26
Date Added to Maude2020-03-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJUDITH LUDWIG
Manufacturer Street1415 W. 3RD STREET
Manufacturer CityTEMPE AZ 85281
Manufacturer CountryUS
Manufacturer Postal85281
Manufacturer Phone4803032689
Manufacturer G1C.R. BARD, INC. (GFO)
Manufacturer Street289 BAY ROAD
Manufacturer CityQUEENSBURY NY 12804
Manufacturer CountryUS
Manufacturer Postal Code12804
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameLUTONIX 035 DRUG COATED BALLOON PTA CATHETER
Generic NameDRUG COATED BALLOON PTA CATHETER
Product CodeONU
Date Received2020-03-09
Returned To Mfg2020-02-26
Model Number9004
Catalog NumberLX3513051205F
Lot NumberGFDN2639
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLUTONIX, INC
Manufacturer Address9409 SCIENCE CENTER DR NEW HOPE MN 55428 US 55428


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-09

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