Brand Name | ACCULAN 3TI DERMATOME |
Type of Device | POWER SYSTEMS |
Manufacturer (Section D) |
AESCULAP AG |
po box 40 |
tuttlingen, 78501 |
GM 78501 |
|
Manufacturer (Section G) |
AESCULAP AG |
po box 40 |
|
tuttlingen, 78501 |
GM
78501
|
|
Manufacturer Contact |
christian
von der grün
|
po box 40 |
tuttlingen, 78501
|
GM
78501
|
|
MDR Report Key | 13499347 |
MDR Text Key | 285354520 |
Report Number | 9610612-2022-00011 |
Device Sequence Number | 1 |
Product Code |
GFD
|
UDI-Device Identifier | 04046963406196 |
UDI-Public | 4046963406196 |
Combination Product (y/n) | N |
Reporter Country Code | EI |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Other,Foreign,Health Professional,Company Representative |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
03/04/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/09/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | GA670 |
Device Catalogue Number | GA670 |
Device Lot Number | 51832536 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 11/05/2021 |
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 02/09/2022 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 03/14/2012 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|