FDA.reportPublic FDA data

MAUDE MDR 9848436

MDR report key
9848436
Report number
3011370111-2020-00021
Event key
0
Event type
3
Date of event
2020-02-27
Date received
2020-03-18
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. GABRIEL ALFAGEME
Address
31 TECHNOLOGY DRIVE IRVINE CA 92618 US
Phone
949-949-9497
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1EMBOTRAP II 5X33 REVASC. DEV.CATHETER, THROMBUS RETRIEVERNEURAVI LTD.NRYET009533ET00953319J187AVR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-1801. H; 2. L; 3. R

Event Narratives#

No narrative records found.