Brand Name | MYOSURE REACH TISSUE REMOVAL DEVICE |
Type of Device | UTERINE TISSUE REMOVAL SYSTEM |
Manufacturer (Section D) |
HOLOGIC, INC. |
250 campus drive |
marlborough, ma |
|
Manufacturer (Section G) |
HOLOGIC, INC. |
250 campus drive |
|
marlborough, ma |
|
Manufacturer Contact |
david
ramsay
|
250 campus drive |
marlborough, ma
|
2638713
|
|
MDR Report Key | 10076802 |
MDR Text Key | 192024957 |
Report Number | 1222780-2020-00079 |
Device Sequence Number | 1 |
Product Code |
HIH
|
UDI-Device Identifier | 35420045504534 |
UDI-Public | (01)35420045504534(10)20A16RA |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K152723 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,user faci |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
05/01/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 01/16/2023 |
Device Model Number | 10-401FC |
Device Catalogue Number | 10-401FC |
Device Lot Number | 20A16RA |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
05/01/2020
|
Initial Date FDA Received | 05/20/2020 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 01/16/2020 |
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 |