Brand Name | VASCULAR PROBES |
Type of Device | DILATOR, VESSEL, SURGICAL |
Manufacturer (Section D) |
SYNOVIS SURGICAL INNOVATIONS |
saint paul MN |
|
Manufacturer (Section G) |
SYNOVIS SURGICAL INNOVATIONS |
2575 university ave w |
|
saint paul MN 55114 |
|
Manufacturer Contact |
|
25212 w. illinois route 120 |
round lake, IL 60073
|
2242702068
|
|
MDR Report Key | 7095182 |
MDR Text Key | 94224809 |
Report Number | 1416980-2017-09614 |
Device Sequence Number | 1 |
Product Code |
DWP
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
PMA/PMN Number | K130896 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
01/11/2018 |
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 |
Other
|
Device Catalogue Number | 7081015ES |
Device Lot Number | SP17D261228263 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 12/01/2017 |
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
11/13/2017
|
Initial Date FDA Received | 12/07/2017 |
Supplement Dates Manufacturer Received | 01/05/2018
|
Supplement Dates FDA Received | 01/11/2018
|
Was Device Evaluated by Manufacturer? |
Yes
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|