Brand Name | IMPRESS |
Type of Device | CATHETER, INTRAVASCULAR, DIAGNOSTIC |
Manufacturer (Section D) |
MERIT MEDICAL SYSTEMS, INC. |
1600 west merit parkway |
south jordan UT 84095 |
|
MDR Report Key | 8431538 |
MDR Text Key | 139224876 |
Report Number | 8431538 |
Device Sequence Number | 1 |
Product Code |
DQO
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
User Facility
|
Reporter Occupation |
Risk Manager
|
Type of Report
| Initial |
Report Date |
03/15/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/19/2019 |
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | 00884450038185 |
Device Catalogue Number | 56535RIM |
Device Lot Number | E1519695 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
No
|
Was the Report Sent to FDA? |
Yes
|
Date Report Sent to FDA | 03/15/2019 |
Event Location |
Hospital
|
Date Report to Manufacturer | 03/19/2019 |
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
Patient Age | 30295 DA |
|
|