Brand Name | BARCO |
Type of Device | SURGICAL DISPLAY |
Manufacturer (Section D) |
BARCO NV |
president kennedypark 35 |
kortrijk, west-vlaanderen 8500 |
BE 8500 |
|
Manufacturer (Section G) |
FIMI SRL |
via saul banfi, 1 |
|
saronno, varese 21047 |
IT
21047
|
|
Manufacturer Contact |
lieven
de wandel
|
president kennedypark 35 |
kortrijk, west-vlaanderen 8500
|
BE
8500
|
|
MDR Report Key | 18986191 |
MDR Text Key | 338701916 |
Report Number | 3004455125-2024-00015 |
Device Sequence Number | 1 |
Product Code |
KQM
|
UDI-Device Identifier | 05415334026568 |
UDI-Public | 05415334026568 |
Combination Product (y/n) | N |
Reporter Country Code | AS |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Distributor |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
02/27/2024 |
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 | MDSC-8231 12G |
Device Catalogue Number | K9352051 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
03/06/2024 |
Initial Date FDA Received | 03/27/2024 |
Was Device Evaluated by Manufacturer? |
Yes
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Life Threatening;
|
|
|