Brand Name | MYOSURE REACH HYSTEROSCOPIC TISSUE REMOVAL SYSTEM |
Type of Device | UTERINE TISSUE REMOVAL SYSTEM |
Manufacturer (Section D) |
HOLOGIC, INC |
250 campus drive |
marlborough MA 01752 |
|
Manufacturer Contact |
kelsea
lyver
|
250 campus drive |
marlborough, MA 01752
|
5082636130
|
|
MDR Report Key | 9248265 |
MDR Text Key | 164085359 |
Report Number | 1222780-2019-00241 |
Device Sequence Number | 1 |
Product Code |
HIH
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K152723 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
10/08/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | 10-401FC |
Device Catalogue Number | 10-401FC |
Device Lot Number | UNKNOWN |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
10/08/2019
|
Initial Date FDA Received | 10/28/2019 |
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 |
N
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
Required Intervention;
|