Brand Name | 2008K AT HOME MACHINE, SHORT CAB, OLC/DP, HP |
Manufacturer (Section D) |
FRESENIUS MEDICAL CARE NORTH AMERICA |
concord CA |
|
Manufacturer (Section G) |
FRESENIUS MEDICAL CARE NORTH AMERICA |
4040 nelson ave. |
|
concord CA 94520 |
|
Manufacturer Contact |
dianne
chin
|
920 winter st. |
waltham, CA 02451-1457
|
7816999105
|
|
MDR Report Key | 3952611 |
MDR Text Key | 4625884 |
Report Number | 2937457-2014-00808 |
Device Sequence Number | 1 |
Product Code |
ONW
|
Combination Product (y/n) | N |
Reporter Country Code | CA |
PMA/PMN Number | K070049 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,User Facility,Company Representative |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
04/11/2014 |
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 |
Lay User/Patient
|
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
04/11/2014
|
Initial Date FDA Received | 05/15/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 04/01/2011 |
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 |
Treatment | UNKNOWN SALINE (DISCARDED NOT USED) |