Brand Name | SENSOR |
Type of Device | SENSOR, GLUCOSE, INVASIVE |
Manufacturer (Section D) |
|
MDR Report Key | 12590162 |
MDR Text Key | 275509492 |
Report Number | MW5104458 |
Device Sequence Number | 2 |
Product Code |
MDS
|
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
10/05/2021 |
2 Devices were Involved in the Event: |
1
2
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
No Information
|
Initial Date Manufacturer Received |
Not provided |
Initial Date FDA Received | 10/06/2021 |
Was Device Evaluated by Manufacturer? |
No Information
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Life Threatening;
Required Intervention;
|
Patient Age | 28 YR |
|
|