Brand Name | TIGERPAW SYSTEM II |
Type of Device | STAPLE, IMPLANTABLE |
Manufacturer (Section D) |
|
Manufacturer Contact |
lioudmila
modylevskaia
|
151 lindbergh ave |
suite i |
livermore, CA 94551
|
9254494108
|
|
MDR Report Key | 4988449 |
MDR Text Key | 23541053 |
Report Number | 3008788191-2015-00086 |
Device Sequence Number | 1 |
Product Code |
GDW
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K111064 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,user faci |
Reporter Occupation |
Physician
|
Remedial Action |
Recall |
Report Date |
07/31/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 08/05/2015 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 05/01/2017 |
Device Model Number | TP15AJ07 |
Device Lot Number | 1137M |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 07/31/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 05/01/2014 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Removal/Correction Number | Z-1461-2015, Z-1462-2015 |
Patient Sequence Number | 1 |
Patient Age | 61 YR |
|
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