MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2020-03-30 for ON-Q C-BLOC PAIN RELIEF SYSTEM WITH ONDEMAND, 400 ML / 5 ML/HR + 5 ML BOLUS/60 CB003 101347103 manufactured by Avanos Medical - Irvine.
| Report Number | 2026095-2020-00044 |
| MDR Report Key | 9896804 |
| Report Source | CONSUMER |
| Date Received | 2020-03-30 |
| Date of Report | 2020-03-30 |
| Date of Event | 2020-03-01 |
| Date Mfgr Received | 2020-03-01 |
| 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 | MS. LISA CLARK |
| Manufacturer Street | 5405 WINDWARD PARKWAY |
| Manufacturer City | ALPHARETTA GA 30004 |
| Manufacturer Country | US |
| Manufacturer Postal | 30004 |
| Manufacturer Phone | 4704485444 |
| Manufacturer G1 | AVENT S. DE R.L. DE C.V. |
| Manufacturer Street | AVE NORUEGA EDIFICIO D-1B FRACCIONAMIENTO RUBIO |
| Manufacturer City | TIJUANA B.C. 22116 |
| Manufacturer Country | MX |
| Manufacturer Postal Code | 22116 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ON-Q C-BLOC PAIN RELIEF SYSTEM WITH ONDEMAND, 400 ML / 5 ML/HR + 5 ML BOLUS/60 |
| Generic Name | ELASTOMERIC - ONDEMAND |
| Product Code | MEB |
| Date Received | 2020-03-30 |
| Model Number | CB003 |
| Catalog Number | 101347103 |
| Lot Number | 0002995277 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AVANOS MEDICAL - IRVINE |
| Manufacturer Address | 43 DISCOVERY SUITE 100 IRVINE CA 92618 US 92618 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-30 |