MAUDE MDR 9887345

MDR report key
9887345
Report number
3012307300-2020-02161
Event key
0
Event type
3
Date received
2020-03-27
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
DAVE HALVERSON
Address
6000 NATHAN LANE N MINNEAPOLIS,, MN US
Phone
383-383-3833
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1LEVEL 1? HOTLINE? LOW FLOW SYSTEMWARMER, THERMAL, INFUSION FLUIDSMITHS MEDICAL ASD; INC.LGZHL-90CON-HL-90R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-270

Event Narratives#

D

Patient 1

INFORMATION WAS RECEIVED INDICATING THAT THERE WAS A SWITCH ISSUE TO A SMITHS MEDICAL LEVEL 1? HOTLINE? LOW FLOW SYSTEM. THERE WERE NO REPORTED ADVERSE EFFECTS.