Brand Name | MASTERSCREEN |
Type of Device | CALCULATOR, PULMONARY FUNCTION DATA |
Manufacturer (Section D) |
VYAIRE MEDICAL GMBH |
leibnizstrasse 7 |
hoechberg, 97204 |
SZ 97204 |
|
Manufacturer (Section G) |
VYAIRE MEDICAL GMBH |
leibnizstrasse 7 |
|
hoechberg, 97204 |
GM
97204
|
|
Manufacturer Contact |
stanley
tan
|
22745 savi ranch pkwy |
yorba linda, CA 92887
|
7149193324
|
|
MDR Report Key | 9504170 |
MDR Text Key | 196222204 |
Report Number | 9615102-2019-00113 |
Device Sequence Number | 1 |
Product Code |
BZC
|
UDI-Device Identifier | 04250892905204 |
UDI-Public | (01)04250892905204 |
Combination Product (y/n) | N |
Reporter Country Code | GM |
PMA/PMN Number | K122699 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
11/22/2019 |
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 Model Number | MASTERSCREEN BODY |
Device Catalogue Number | V-175423 |
Was Device Available for Evaluation? |
Yes
|
Initial Date Manufacturer Received |
11/22/2019
|
Initial Date FDA Received | 12/20/2019 |
Was Device Evaluated by Manufacturer? |
No
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
|
|