Brand Name | INSORB 30 STAPLER |
Type of Device | INSORB 30 STAPLER |
Manufacturer (Section D) |
COOPERSURGICAL, INC. |
95 corporate drive |
trumbull CT 06611 |
|
Manufacturer (Section G) |
COOPERSURGICAL, INC, |
75 corporate drive |
|
trumbull CT 06611 |
|
Manufacturer Contact |
michael
marone
|
50 corporate drive |
trumbull, CT 06611
|
4752651665
|
|
MDR Report Key | 15397607 |
MDR Text Key | 299964777 |
Report Number | 1216677-2022-00262 |
Device Sequence Number | 1 |
Product Code |
GDW
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
09/08/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Model Number | 2030 |
Device Catalogue Number | 2030 |
Device Lot Number | ASKU |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
08/30/2022
|
Initial Date FDA Received | 09/10/2022 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
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 |
Patient Outcome(s) |
Other;
|
|
|