Brand Name | JOEY 1000ML PUMP SET |
Type of Device | PUMP, INFUSION, ENTERAL |
Manufacturer (Section D) |
CARDINAL HEALTH |
777 west street |
mansfield MA 02048 |
|
Manufacturer (Section G) |
CARDINAL HEALTH |
calle 9 sur no. 125 cuidad ind |
|
tijuana 22500 |
MX
22500
|
|
Manufacturer Contact |
jill
saraiva
|
777 west street |
mansfield, MA 02048
|
5086183640
|
|
MDR Report Key | 19004267 |
MDR Text Key | 338913080 |
Report Number | 9612030-2024-00052 |
Device Sequence Number | 1 |
Product Code |
LZH
|
UDI-Device Identifier | 10884521072305 |
UDI-Public | 10884521072305 |
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
User Facility,Company Representative |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
03/29/2024 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/29/2024 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Model Number | 763656 |
Device Catalogue Number | 763656 |
Device Lot Number | 2323300764 |
Was Device Available for Evaluation? |
No
|
Date Manufacturer Received | 03/17/2024 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
A
|
Patient Sequence Number | 1 |
|
|