Brand Name | EUFLEXXA 20 MG/2ML (6=3 SYR) |
Type of Device | ACID, HYALURONIC, INTRAARTICULAR |
Manufacturer (Section D) |
BIO-TECHNOLOGY GENERAL (ISRAEL) LTD. |
|
|
MDR Report Key | 18159758 |
MDR Text Key | 328600639 |
Report Number | MW5148244 |
Device Sequence Number | 1 |
Product Code |
MOZ
|
UDI-Device Identifier | 55566410001 |
UDI-Public | 55566410001 |
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
11/13/2023 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Lot Number | U17230A |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 11/16/2023 |
Patient Sequence Number | 1 |
Treatment | AMLODIPINE TAB 10MG.; ASPIRIN CHW 81MG.; ATORVASTATIN TAB 40MG.; AZEUFLUTIC SPR 137-50.; CIALIS TAB 5MG.; DYAZIDE CAP 37.5-25.; EFFIENT TAB 10MG.; ELIQUIS TAB 2.5MG.; FIBER TAB 625MG.; FLUTICASONE SPR 50MCG.; GLUCOS/CHOND TAB 500-400.; LEVOTHYROXIN TAB 150MCG.; METOPROL TAR TAB 25MG.; MONTELUKAST TAB 10MG.; MULTI-VITAMIN TAB.; NUCALA INJ 100MG.; POT CL MICRO TAB 20MEQ ER. ; SPIRIVA CAP HANDIHLR.; SYMBICORT AER 160-4.5.; TAMSULOSIN CAP 0.4MG.; TRELEGY AER 200MCG.; TRIAMT/HCTZ TAB 37.5-25.; VENTOLIN HFA AER.; VITAMIN B12 TAB 100MCG. |
Patient Outcome(s) |
Other;
|
Patient Age | 80 YR |
Patient Sex | Male |