CODA LP BALLOON CATHETER CODA-2-9.0-35-120-32

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,o report with the FDA on 2020-03-27 for CODA LP BALLOON CATHETER CODA-2-9.0-35-120-32 manufactured by Cook Inc.

MAUDE Entry Details

Report Number1820334-2020-00703
MDR Report Key9889913
Report SourceFOREIGN,HEALTH PROFESSIONAL,O
Date Received2020-03-27
Date of Report2020-03-27
Date of Event2020-03-16
Date Mfgr Received2020-03-16
Device Manufacturer Date2019-12-17
Date Added to Maude2020-03-27
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 ContactMRS. JENNIFER CANADA
Manufacturer Street750 DANIELS WAY
Manufacturer CityBLOOMINGTON IN 47404
Manufacturer CountryUS
Manufacturer Postal47404
Manufacturer Phone8123392235
Manufacturer G1COOK INC
Manufacturer Street750 DANIELS WAY
Manufacturer CityBLOOMINGTON IN 47404
Manufacturer CountryUS
Manufacturer Postal Code47404
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCODA LP BALLOON CATHETER
Generic NameDQY CATHETER, PERCUTANEOUS
Product CodeDQY
Date Received2020-03-27
Catalog NumberCODA-2-9.0-35-120-32
Lot Number10217433
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCOOK INC
Manufacturer Address750 DANIELS WAY BLOOMINGTON IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-27

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