Brand Name | MAHURKAR ELITE |
Type of Device | CATHETER, HEMODIALYSIS, NON-IMPLANTED |
Manufacturer (Section D) |
COVIDIEN MFG SOLUTIONS S.A. |
edificio b20, calle #2 |
alajuela 20101 |
|
Manufacturer (Section G) |
COVIDIEN MFG SOLUTIONS S.A. |
edificio b20, calle #2 |
|
alajuela 20101 |
|
Manufacturer Contact |
lisa
hernandez
|
15 hampshire street |
mansfield, MA 02048
|
2034925563
|
|
MDR Report Key | 9601119 |
MDR Text Key | 175373912 |
Report Number | 3009211636-2020-00018 |
Device Sequence Number | 1 |
Product Code |
MPB
|
UDI-Device Identifier | 10884521126015 |
UDI-Public | 10884521126015 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K120674 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
user facility |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
01/17/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 01/17/2020 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 11/18/2020 |
Device Model Number | 8888211416 |
Device Catalogue Number | 8888211416 |
Device Lot Number | 1835100092 |
Was Device Available for Evaluation? |
No
|
Date Manufacturer Received | 12/31/2019 |
Date Device Manufactured | 03/01/2019 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
|
|