MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-03-11 for ARROW 260567 manufactured by Fh Industrie.
| Report Number | 3003898228-2020-00003 |
| MDR Report Key | 9816993 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2020-03-11 |
| Date of Report | 2020-03-12 |
| Date of Event | 2020-01-21 |
| Date Mfgr Received | 2020-02-12 |
| Device Manufacturer Date | 2018-10-24 |
| Date Added to Maude | 2020-03-11 |
| 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 | MS. C HERNOUX |
| Manufacturer Street | 3 RUE DE LA FOR |
| Manufacturer City | HEIMSBRUNN, 68990 |
| Manufacturer Country | FR |
| Manufacturer Postal | 68990 |
| Manufacturer G1 | FH INDUSTRIE |
| Manufacturer Street | 6 RUE NOBEL |
| Manufacturer City | QUIMPER, 29000 |
| Manufacturer Country | FR |
| Manufacturer Postal Code | 29000 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ARROW |
| Generic Name | ARROW GLENOSPHERE ?39 |
| Product Code | KWT |
| Date Received | 2020-03-11 |
| Returned To Mfg | 2020-02-12 |
| Catalog Number | 260567 |
| Lot Number | J01031 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | FH INDUSTRIE |
| Manufacturer Address | 6 RUE NOBEL QUIMPER, 29000 FR 29000 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-03-11 |