Brand Name | INTELLIVUE MULTI MEASUREMENT SERVER X2 |
Type of Device | INTELLIVUE MULTI MEASUREMENT SERVER X2 |
Manufacturer (Section D) |
PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH |
hewlett-packard-str. 2, |
b1-3/d6 |
boblingen 71034 |
GM 71034 |
|
Manufacturer (Section G) |
PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH |
hewlett-packard-str. 2, |
b1-3/d6 |
boblingen 71034 |
GM
71034
|
|
Manufacturer Contact |
derek
sammarco
|
222 jacobs st |
cambridge, MA 02141
|
6172455900
|
|
MDR Report Key | 14787163 |
MDR Text Key | 294586528 |
Report Number | 9610816-2022-00341 |
Device Sequence Number | 1 |
Product Code |
DSI
|
UDI-Device Identifier | 00884838000261 |
UDI-Public | 00884838000261 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K150310 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | M3002A |
Device Catalogue Number | M3002A |
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
05/30/2022
|
Initial Date FDA Received | 06/23/2022 |
Supplement Dates Manufacturer Received | 05/30/2022
|
Supplement Dates FDA Received | 11/09/2022
|
Date Device Manufactured | 09/16/2016 |
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 Outcome(s) |
Required Intervention;
|
|
|