Brand Name | WOLF LITHOTRIPTOR PROBE |
Type of Device | LITHOTRIPTOR PROBE |
Manufacturer (Section D) |
|
MDR Report Key | 4824992 |
MDR Text Key | 20718784 |
Report Number | MW5042950 |
Device Sequence Number | 1 |
Product Code |
FFK
|
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Risk Manager
|
Type of Report
| Initial |
Report Date |
03/21/2015 |
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 | 2135.0905 |
Device Lot Number | 271131 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 05/22/2015 |
Patient Sequence Number | 1 |
Patient Age | 80 YR |
Patient Weight | 22 |
|
|