FDA.reportPublic FDA data

MAUDE MDR 9844833

MDR report key
9844833
Report number
3014527682-2020-00004
Event key
0
Event type
3
Date of event
2020-02-03
Date received
2020-03-17
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
3
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MRS CHEYENNE STEWART
Address
3000 EAST SAWYER ROAD REPUBLIC, MO US
Phone
730-730-7303
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DEROYAL ESMARK BANDAGESESMARK, BANDAGE 4X9FTDEROYAL INDUSTRIESFQM30-19650118138N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-170

Event Narratives#

No narrative records found.