Brand Name | CODMAN EXT DRAINAGE SYSTEM III WITHOUT VENT CATH |
Type of Device | SHUNT, CENTRAL NERVOUS SYSTEM & COMPS |
Manufacturer (Section D) |
NATUS NEURO INCORPORATED |
3150 pleasant view road |
middleton WI 53562 |
|
Manufacturer (Section G) |
NATUS NEUROLOGY INCORPORATED |
5955 pacific center boulevard |
|
san diego CA 92121 |
|
Manufacturer Contact |
janessa
boone
|
3150 pleasant view road |
middleton, WI 53562
|
6088298603
|
|
MDR Report Key | 8345844 |
MDR Text Key | 136856002 |
Report Number | 3010611950-2019-00009 |
Device Sequence Number | 1 |
Product Code |
JXG
|
UDI-Device Identifier | 10886704040910 |
UDI-Public | 10886704040910 |
Combination Product (y/n) | N |
Reporter Country Code | IT |
PMA/PMN Number | K954021 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
user facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
01/15/2019 |
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 Model Number | 821731 |
Device Catalogue Number | 821731 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
01/15/2019
|
Initial Date FDA Received | 02/15/2019 |
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;
|