MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,study report with the FDA on 2020-03-27 for NEUROBLATE? SYSTEM 20980 NB102 manufactured by Monteris Medical.
[186805639]
It was reported that following an ablation procedure, the patient experienced worsening left hemiparesis. The patient was prescribed steroids and physical therapy. The patient was then discharged from the hospital on (b)(6) 2020. The event was considered ongoing when the patient was discharged and possibly related to the surgical procedure. The patient has since expired on (b)(6) 2020 which was not related to the event.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3009970070-2020-00031 |
| MDR Report Key | 9889654 |
| Report Source | COMPANY REPRESENTATIVE,STUDY |
| Date Received | 2020-03-27 |
| Date of Report | 2020-03-27 |
| Date of Event | 2020-01-16 |
| Date Mfgr Received | 2020-03-19 |
| Device Manufacturer Date | 2016-03-25 |
| Date Added to Maude | 2020-03-27 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | JORDON HONECK |
| Manufacturer Street | 14755 27TH AVE N SUITE C |
| Manufacturer City | PLYMOUTH, MN |
| Manufacturer Country | US |
| Manufacturer G1 | MONTERIS MEDICAL |
| Manufacturer Street | 14755 27TH AVE N SUITE C |
| Manufacturer City | PLYMOUTH, MN |
| Manufacturer Country | US |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NEUROBLATE? SYSTEM |
| Generic Name | NEUROBLATE? SYSTEM |
| Product Code | GEX |
| Date Received | 2020-03-27 |
| Model Number | 20980 |
| Catalog Number | NB102 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MONTERIS MEDICAL |
| Manufacturer Address | 14755 27TH AVE N SUITE C PLYMOUTH, MN US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-03-27 |