FDA.reportPublic FDA data

MAUDE MDR 9908707

MDR report key
9908707
Report number
0001056128-2020-00022
Event key
0
Event type
3
Date of event
2020-01-29
Date received
2020-03-31
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. MARISSA RICHMOND
Address
1810 W. DRAKE DRIVE TEMPE AZ 85283 US
Phone
888-888-8888
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1NAELECTROSURGICAL, CUTTING & COAGULATION ACCESSORIES, LAPAROSCOPIC & ENDOSCOPIC, RSTRYKER SUSTAINABILITY SOLUTIONS LAKELANDNUJLF1737LF1737RR10917213Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-310

Event Narratives#

No narrative records found.