Brand Name | USCH GREENLITE DISP MTL MILL 0 |
Type of Device | LARYNGOSCOPE, RIGID |
Manufacturer (Section D) |
|
Manufacturer (Section G) |
TRUPHATEK INTERNATIONAL LTD. |
14 benny gaon street |
p.o. 8051 |
netanya 42504 43 |
IS
4250443
|
|
Manufacturer Contact |
katharine
tarpley
|
3015 carrington mill blvd |
morrisville, NC 27560
|
|
MDR Report Key | 14189219 |
MDR Text Key | 290461183 |
Report Number | 8030121-2022-00015 |
Device Sequence Number | 1 |
Product Code |
CCW
|
UDI-Device Identifier | 14026710625992 |
UDI-Public | 14026710625992 |
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility,Company Representative |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
03/28/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 04/22/2022 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Expiration Date | 01/30/2022 |
Device Model Number | IPN048378 |
Device Catalogue Number | 004550000 |
Device Lot Number | 1711401 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 04/07/2022 |
Is the Reporter a Health Professional? |
No
|
Date Manufacturer Received | 05/16/2022 |
Was Device Evaluated by Manufacturer? |
Yes
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Treatment | NONE REPORTED; NONE REPORTED |
|
|