FDA.reportPublic FDA data

MAUDE MDR 9833037

MDR report key
9833037
Report number
3012931345-2020-00040
Event key
0
Event type
3
Date of event
2019-12-28
Date received
2020-03-14
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. TARA LOPEZ
Address
47900 BAYSIDE PARKWAY FREMONT CA 94538 US
Phone
510-510-5104
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1TREVO XP PROVUE 3MM X 20MMCATHETER, THROMBUS RETRIEVERSTRYKER NEUROVASCULAR-UTAH-SALT LAKE CITYNRY90183901830000014827R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-1401. O

Event Narratives#

No narrative records found.