Brand Name | 20/30 PRIORITY PACK ACCESSORY KIT |
Type of Device | ACCESSORIES |
Manufacturer (Section D) |
ABBOTT VASCULAR |
26531 ynez rd. |
temecula CA 92591 4628 |
|
Manufacturer (Section G) |
ABBOTT VASCULAR, REG # 2024168 |
26531 ynez road |
|
temecula CA 92591 4628 |
|
Manufacturer Contact |
lindsey
bell
|
26531 ynez rd. |
temecula, CA 92591-4628
|
9519143996
|
|
MDR Report Key | 19097308 |
MDR Text Key | 340108120 |
Report Number | 2024168-2024-04615 |
Device Sequence Number | 1 |
Product Code |
MAV
|
UDI-Device Identifier | 08717648013614 |
UDI-Public | (01)08717648013614(17)250831(10)60498707 |
Combination Product (y/n) | N |
Reporter Country Code | DR |
PMA/PMN Number | K961471 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
04/12/2024 |
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 Catalogue Number | 1000186 |
Device Lot Number | 60498707 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
03/22/2024
|
Initial Date FDA Received | 04/12/2024 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 09/23/2023 |
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 |