Brand Name | ANASTOCLIP VCS CLOSURE SYSTEM |
Type of Device | CLIP, IMPLANTABLE AND DELIVERY SYSTEM |
Manufacturer (Section D) |
LEMAITRE VASCULAR, INC. |
63 second ave |
burlington MA 01803 |
|
Manufacturer (Section G) |
LEMAITRE VASCULAR, INC. |
63 second ave |
|
burlington MA 01803 |
|
Manufacturer Contact |
pragya
thikey
|
63 second ave |
burlington, MA 01803
|
7812212266
|
|
MDR Report Key | 8458458 |
MDR Text Key | 140306042 |
Report Number | 1220948-2019-00032 |
Device Sequence Number | 1 |
Product Code |
FZP
|
UDI-Device Identifier | 00840663102372 |
UDI-Public | 00840663102372 |
Combination Product (y/n) | N |
PMA/PMN Number | K091987 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
03/27/2019 |
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 Expiration Date | 01/28/2023 |
Device Catalogue Number | 4000-07 |
Device Lot Number | ANC2194 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 03/04/2019 |
Initial Date Manufacturer Received |
02/25/2019
|
Initial Date FDA Received | 03/27/2019 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 02/23/2018 |
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 |