| Brand Name | OOK SNOW |
| Common Device Name | HOSPITAL BED |
| Manufacturer (Section D) |
| UMANO MEDICAL INC. |
| 230 boulevard nilus-leclerc |
| l'islet, G0R 2 C0 |
| CA G0R 2C0 |
|
| Manufacturer (Section G) |
| UMANO MEDICAL INC. |
| 230 boulevard nilus-leclerc |
|
| l'islet, qc G0R 2 C0 |
|
CA
G0R 2C0
|
|
| Manufacturer Contact |
|
saoussen
gammoudi
|
| 230 boulevard nilus-leclerc |
| l'islet, qc G0R 2-C0
|
|
CA
G0R 2C0
|
|
| MDR Report Key | 12959696 |
| Report Number | 3009591865-2021-00025 |
| Device Sequence Number | 1792875 |
| Product Code |
FNL
|
| UDI-Device Identifier | 00670482000067 |
| UDI-Public | 010067048200006711160107 |
| Combination Product (Y/N) | N |
| Initial Reporter State | SC |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
12/08/2021 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Model Number | FL36 |
| Was Device Available for Evaluation? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 11/08/2021 |
| Initial Report FDA Received Date | 12/08/2021 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 01/07/2016 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|