Brand Name | ENDOCARE URETHRAL WARMING SYSTEM |
Type of Device | UNIT, CRYOSURGICAL, ACCESSORIES |
Manufacturer (Section D) |
ENDOCARE INC. |
9825 spectrum dr. |
building 2 |
austin TX 78717 |
|
Manufacturer (Section G) |
ENDOCARE INC. |
9825 spectrum dr. |
building 2 |
austin TX 78717 |
|
Manufacturer Contact |
deborah
wilcoxen
|
9825 spectrum dr. |
building 2 |
austin, TX 78717
|
5125181743
|
|
MDR Report Key | 8625147 |
MDR Text Key | 145758689 |
Report Number | 3008262715-2019-00076 |
Device Sequence Number | 1 |
Product Code |
GEH
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K153489 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
07/29/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 05/20/2019 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | CRYO-63 |
Device Catalogue Number | CRYO-63 |
Device Lot Number | R16271-5 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 07/29/2019 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 12/01/2014 |
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 Age | 73 YR |