MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-30 for ENDO ANCHOR SYSTEM - HELI-FX AAA SA-85 manufactured by Medtronic Ireland.
| Report Number | 9612164-2020-01394 | 
| MDR Report Key | 9896793 | 
| Report Source | COMPANY REPRESENTATIVE,FOREIG | 
| Date Received | 2020-03-30 | 
| Date of Report | 2020-03-30 | 
| Date of Event | 2020-01-27 | 
| Date Mfgr Received | 2020-03-20 | 
| Device Manufacturer Date | 2018-09-25 | 
| Date Added to Maude | 2020-03-30 | 
| 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 | ALISON SWEENEY | 
| Manufacturer Street | PARKMORE BUSINESS PARK WEST | 
| Manufacturer City | GALWAY | 
| Manufacturer Country | IE | 
| Manufacturer Phone | 091708096 | 
| Manufacturer G1 | MEDTRONIC IRELAND | 
| Manufacturer Street | PARKMORE BUSINESS PARK WEST | 
| Manufacturer City | GALWAY | 
| Manufacturer Country | IE | 
| Single Use | 3 | 
| Previous Use Code | 3 | 
| Event Type | 3 | 
| Type of Report | 3 | 
| Brand Name | ENDO ANCHOR SYSTEM - HELI-FX AAA | 
| Generic Name | ENDOVASCULAR SUTURING SYSTEM | 
| Product Code | OTD | 
| Date Received | 2020-03-30 | 
| Model Number | SA-85 | 
| Catalog Number | SA-85 | 
| Lot Number | 0009344783 | 
| Operator | HEALTH PROFESSIONAL | 
| Device Availability | N | 
| Device Eval'ed by Mfgr | * | 
| Device Sequence No | 1 | 
| Device Event Key | 0 | 
| Manufacturer | MEDTRONIC IRELAND | 
| Manufacturer Address | PARKMORE BUSINESS PARK WEST GALWAY IE | 
| Patient Number | Treatment | Outcome | Date | 
|---|---|---|---|
| 1 | 0 | 2020-03-30 |