Brand Name | SIERRA SUMMIT |
Type of Device | ELECTROMYOGRAPH, DIAGNOSTIC |
Manufacturer (Section D) |
CADWELL INDUSTRIES, INC. |
909 n kellogg st |
kennewick WA 99336 |
|
MDR Report Key | 15904337 |
MDR Text Key | 304685894 |
Report Number | 15904337 |
Device Sequence Number | 1 |
Product Code |
IKN
|
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 |
11/28/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 12/02/2022 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Model Number | 190274-200 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Was the Report Sent to FDA? |
Yes
|
Date Report Sent to FDA | 11/28/2022 |
Event Location |
Other
|
Date Report to Manufacturer | 12/02/2022 |
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Patient Age | 22995 DA |
Patient Sex | Female |
|
|