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MAUDE Adverse Event Report: NULL
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Device Problem
Device Damaged Prior to Use (2284)
Patient Problem
No Clinical Signs, Symptoms or Conditions (4582)
Event Type
malfunction
Event Description
It was reported per medwatch mw5105945: the patient reported a faulty cassette.No patient injury reported.
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Manufacturer
(Section G)
NULL
MDR Report Key
13471841
MDR Text Key
287803248
Report Number
3012307300-2022-02571
Device Sequence Number
1
Product Code
LHI
Combination Product (y/n)
N
Reporter Country Code
US
Number of Events Reported
1
Summary Report (Y/N)
N
Report Source
Manufacturer
Source Type
Other
Reporter Occupation
Other Health Care Professional
Type of Report
Initial
Report Date
02/07/2022
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
Was Device Available for Evaluation?
No
Is the Reporter a Health Professional?
Yes
Was the Report Sent to FDA?
No
Initial Date Manufacturer Received
01/19/2022
Initial Date FDA Received
02/07/2022
Was Device Evaluated by Manufacturer?
Device Not Returned to Manufacturer
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 Sex
Female
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