Brand Name | DIALYSIS UNKNOWN |
Type of Device | CATHETER, PERITONEAL, LONG-TERM INDWELLING |
Manufacturer (Section D) |
COVIDIEN MFG SOLUTIONS S.A. |
edificio b20, calle #2 |
alajuela 20101 |
CR 20101 |
|
Manufacturer (Section G) |
COVIDIEN MFG SOLUTIONS S.A. |
edificio b20, calle #2 |
|
alajuela 20101 |
CR
20101
|
|
Manufacturer Contact |
lisa
hernandez
|
15 hampshire street |
mansfield, MA 02048
|
2034925563
|
|
MDR Report Key | 10784135 |
MDR Text Key | 214525823 |
Report Number | 3009211636-2020-00273 |
Device Sequence Number | 1 |
Product Code |
FJS
|
Combination Product (y/n) | N |
Reporter Country Code | BR |
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 |
11/04/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 11/04/2020 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | DIALYSIS UNKNOWN |
Device Catalogue Number | DIALYSIS UNKNOWN |
Device Lot Number | 171010025 |
Was Device Available for Evaluation? |
No
|
Date Manufacturer Received | 10/20/2020 |
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 |
|
|