MAUDE MDR 9908792

MDR report key
9908792
Report number
2031527-2020-00122
Event key
0
Event type
3
Date of event
2020-03-04
Date received
2020-03-31
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. EMILE PINSONNEAULT
Address
3910 BRICKWAY BLVD , SANTA ROSA CA 95403 US
Phone
800-800-8009
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1AFX2BIFURCATED STENT GRAFTENDOLOGIXMIHBEA28-100/I20-401354807-002R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-3101. O

Event Narratives#

No narrative records found.