Brand Name | VASCULAR PROBES |
Type of Device | DILATOR, VESSEL, SURGICAL |
Manufacturer (Section D) |
SYNOVIS SURGICAL INNOVATIONS |
2575 university ave. w |
saint paul MN 55144 |
|
Manufacturer (Section G) |
SYNOVIS SURGICAL INNOVATIONS |
2575 university ave. w |
|
saint paul MN 55144 |
|
Manufacturer Contact |
kinga
almasan
|
25212 w. illinois route 120 |
round lake, IL 60073
|
2242702068
|
|
MDR Report Key | 4946247 |
MDR Text Key | 6255778 |
Report Number | 1416980-2015-30382 |
Device Sequence Number | 1 |
Product Code |
DWP
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
PMA/PMN Number | K130896 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Company Representative,Distributor,company representati |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
09/08/2015 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 07/28/2015 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Expiration Date | 03/20/2019 |
Device Catalogue Number | 7452025 |
Device Lot Number | SPCE31502B0059 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 07/23/2015 |
Is the Reporter a Health Professional? |
No
|
Date Manufacturer Received | 09/02/2015 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 03/20/2014 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |