Brand Name | ARCHITECT LACTIC ACID |
Type of Device | LACTIC ACID |
Manufacturer (Section D) |
ABBOTT MANUFACTURING INC |
1921 hurd drive |
irving TX 75038 |
|
Manufacturer (Section G) |
ABBOTT MANUFACTURING INC |
1921 hurd drive |
|
irving TX 75038 |
|
Manufacturer Contact |
noemi
romero-kondos, rn bsn
|
100 abbott park road |
dept. 09b9, lccp1-3 |
abbott park, IL 60064-3537
|
224667-512
|
|
MDR Report Key | 6133064 |
MDR Text Key | 61086905 |
Report Number | 1628664-2016-00290 |
Device Sequence Number | 1 |
Product Code |
KHP
|
Combination Product (y/n) | N |
Reporter Country Code | UK |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,health professional |
Reporter Occupation |
Physician
|
Remedial Action |
Notification |
Type of Report
| Initial |
Report Date |
11/29/2016 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 11/29/2016 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | 09D89-21 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 11/16/2016 |
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 |
N
|
Removal/Correction Number | 1628664-10/11/16-001-C |
Patient Sequence Number | 1 |
Treatment | ARCHITECT C16000 SYSTEM; LIST (B)(4), SERIAL (B)(4) |
|
|