Brand Name | HLS SET ADVANCED |
Type of Device | OXYGENATOR, CARDIOPULMONARY BYPASS |
Manufacturer (Section D) |
MAQUET CARDIOPULMONARY GMBH |
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Manufacturer (Section G) |
JULIA KAPFENBERGER |
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Manufacturer Contact |
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MDR Report Key | 12369189 |
MDR Text Key | 268195267 |
Report Number | 8010762-2021-00474 |
Device Sequence Number | 1 |
Product Code |
DTZ
|
Combination Product (y/n) | N |
Reporter Country Code | PO |
PMA/PMN Number | K102726 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Consumer,Health Professional,User Facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
12/20/2021 |
1 Device was Involved in the Event |
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0 Patients were Involved in the Event: |
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Date FDA Received | 08/26/2021 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
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Device Expiration Date | 04/01/2022 |
Device Model Number | BE-HLS-7050 |
Device Catalogue Number | 701069073 |
Device Lot Number | 3000165548 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 10/04/2021 |
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
Yes
|
Date Manufacturer Received | 11/29/2021 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 04/19/2021 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|