TREVO XP PROVUE 3MM X 20MM 90183

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-03-14 for TREVO XP PROVUE 3MM X 20MM 90183 manufactured by Stryker Neurovascular-utah-salt Lake City.

MAUDE Entry Details

Report Number3012931345-2020-00040
MDR Report Key9833037
Report SourceHEALTH PROFESSIONAL
Date Received2020-03-14
Date of Report2020-04-02
Date of Event2019-12-28
Date Mfgr Received2020-04-02
Device Manufacturer Date2018-09-14
Date Added to Maude2020-03-14
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 ContactMR. TARA LOPEZ
Manufacturer Street47900 BAYSIDE PARKWAY
Manufacturer CityFREMONT CA 94538
Manufacturer CountryUS
Manufacturer Postal94538
Manufacturer Phone5104132500
Manufacturer G1STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY
Manufacturer Street4870 WEST 2100 SOUTH
Manufacturer CitySALT LAKE CITY UT 84120
Manufacturer CountryUS
Manufacturer Postal Code84120
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTREVO XP PROVUE 3MM X 20MM
Generic NameCATHETER, THROMBUS RETRIEVER
Product CodeNRY
Date Received2020-03-14
Model Number90183
Catalog Number90183
Lot Number0000014827
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY
Manufacturer Address4870 WEST 2100 SOUTH SALT LAKE CITY UT 84120 US 84120


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-14

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