Brand Name | IMPRESS® BRAIDED CATHETER |
Type of Device | CATHETER, INTRAVASCULAR, DIAGNOSTIC |
Manufacturer (Section D) |
MERIT MEDICAL SYSTEMS INC. |
14646 kirby drive |
houston TX 77047 |
|
Manufacturer (Section G) |
MERIT MEDICAL SYSTEMS INC. |
14646 kirby drive |
|
houston TX 77047 |
|
Manufacturer Contact |
bryson
heaton
|
1600 merit parkway |
south jordan, UT 84095
|
|
MDR Report Key | 17958912 |
MDR Text Key | 325966788 |
Report Number | 3010665433-2023-00089 |
Device Sequence Number | 1 |
Product Code |
DQO
|
UDI-Device Identifier | 00884450032534 |
UDI-Public | 884450032534 |
Combination Product (y/n) | N |
Reporter Country Code | IN |
PMA/PMN Number | K053171 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,User Facility,Company Representative |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
10/10/2023 |
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 Operator |
Health Professional
|
Device Catalogue Number | 512535HH1 |
Device Lot Number | E2161251 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
10/10/2023
|
Initial Date FDA Received | 10/18/2023 |
Supplement Dates Manufacturer Received | 12/08/2023
|
Supplement Dates FDA Received | 12/13/2023
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 08/12/2021 |
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 |