Brand Name | GREENLIGHT MOXY FIBER OPTIC |
Type of Device | POWERED LASER SURGICAL INSTRUMENT |
Manufacturer (Section D) |
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) |
3070 orchard drive |
san jose CA 95134 |
|
Manufacturer (Section G) |
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) |
3070 orchard drive |
|
san jose CA 95134 |
|
Manufacturer Contact |
alyson
harris
|
3070 orchard drive |
san jose, CA 95134
|
4084563300
|
|
MDR Report Key | 8055938 |
MDR Text Key | 126956237 |
Report Number | 2937094-2018-01079 |
Device Sequence Number | 1 |
Product Code |
GEX
|
Combination Product (y/n) | N |
Reporter Country Code | IT |
PMA/PMN Number | NA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
11/29/2016 |
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 Expiration Date | 04/30/2018 |
Device Model Number | 0010-2400 |
Device Catalogue Number | 0010-2400 |
Device Lot Number | 617A |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 10/26/2018 |
Initial Date Manufacturer Received |
11/07/2018
|
Initial Date FDA Received | 11/09/2018 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 04/25/2016 |
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |