MICROVASCULAR PLUG MVP-5Q

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,literatur report with the FDA on 2020-03-18 for MICROVASCULAR PLUG MVP-5Q manufactured by Reverse Medical Corporation.

MAUDE Entry Details

Report Number3007170829-2020-00004
MDR Report Key9851069
Report SourceHEALTH PROFESSIONAL,LITERATUR
Date Received2020-03-18
Date of Report2020-03-18
Date of Event2019-11-25
Date Mfgr Received2020-03-08
Date Added to Maude2020-03-18
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 ContactKATCHA TAYLOR
Manufacturer Street9775 TOLEDO WAY
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal92618
Manufacturer Phone9496801345
Manufacturer G1REVERSE MEDICAL CORPORATION
Manufacturer Street13700 ALTON PARKWAY
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal Code92618
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMICROVASCULAR PLUG
Product CodeKRD
Date Received2020-03-18
Model NumberMVP-5Q
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerREVERSE MEDICAL CORPORATION
Manufacturer Address13700 ALTON PARKWAY IRVINE CA 92618 US 92618


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-18

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