Brand Name | CENTURION CLAMP |
Type of Device | CLAMP |
Manufacturer (Section D) |
CENTURION MEDICAL PRODUCTS, LP |
|
|
MDR Report Key | 17351433 |
MDR Text Key | 319396036 |
Report Number | MW5119590 |
Device Sequence Number | 1 |
Product Code |
HFX
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Risk Manager
|
Type of Report
| Initial |
Report Date |
07/13/2023 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 07/17/2023 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | CIT5935A |
Device Lot Number | 23ABQ353 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
Patient Age | 1 DA |
Patient Sex | Male |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|