Brand Name | LUCAS ® CPR CHEST COMPRESSION SYSTEM |
Type of Device | COMPRESSOR, CARDIAC, EXTERNAL |
Manufacturer (Section D) |
JOLIFE AB - 3005445717 |
scheelevagen 17 |
ideon science park |
lund SE-22 3 70 |
SW SE-223 70 |
|
Manufacturer (Section G) |
JOLIFE AB - 3005445717 |
scheelevagen 17 |
ideon science park |
lund SE-22 3 70 |
SW
SE-223 70
|
|
Manufacturer Contact |
todd
bandy
|
11811 willows road ne |
redmond, WA 98052
|
4258674000
|
|
MDR Report Key | 16131648 |
MDR Text Key | 307013844 |
Report Number | 0003015876-2023-00045 |
Device Sequence Number | 1 |
Product Code |
DRM
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K090422 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Distributor
|
Source Type |
Health Professional |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
06/29/2020,01/10/2023 |
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? |
No
|
Device Operator |
Health Professional
|
Device Model Number | LUCAS |
Device Catalogue Number | 99576-000024 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
No
|
Distributor Facility Aware Date | 06/29/2020 |
Device Age | 0 YR |
Event Location |
Hospital
|
Date Report to Manufacturer | 06/29/2020 |
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 01/10/2023 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
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;
|
Patient Age | 82 YR |
Patient Sex | Male |