Brand Name | HUDSON CIRCUIT, HTD DUAL LIMB W/WATER TRAPS W/O |
Type of Device | BREATHING CIRCUIT |
Manufacturer (Section D) |
|
Manufacturer Contact |
margie
burton, rn
|
p.o. box 12600 |
durham, NC 27709
|
9194334965
|
|
MDR Report Key | 4019377 |
MDR Text Key | 4847187 |
Report Number | 3004365956-2014-00263 |
Device Sequence Number | 1 |
Product Code |
CAG
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility,Company Representative |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
06/23/2014 |
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 |
Health Professional
|
Device Catalogue Number | 780-36 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
06/23/2014
|
Initial Date FDA Received | 07/10/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
|
|