| Brand Name | MEDEX LOGICAL TRANSDUCERS |
| Common Device Name | TRANSDUCER, BLOOD-PRESSURE, EXTRAVASCULAR |
| Manufacturer (Section D) |
| SMITHS MEDICAL ASD, INC. |
| 6250 shier rings road |
| dublin OH 43016 |
|
| Manufacturer (Section G) |
| SMITHS MEDICAL ASD, INC. |
| 6250 shier rings road |
|
| dublin OH 43016 |
|
| Manufacturer Contact |
|
jim
vegel
|
| 6000 nathan lane north |
| jiangdong street |
| minneapolis, MN 55442
|
|
| MDR Report Key | 13386311 |
| Report Number | 3012307300-2022-02084 |
| Device Sequence Number | 11995837 |
| Product Code |
DRS
|
| UDI-Device Identifier | 10351688502988 |
| UDI-Public | 10351688502988 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K961404 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Company Representative |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
01/28/2022 |
| 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 | MX960 |
| Device Catalogue Number | MX960 |
| Device Lot Number | LR414 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 08/30/2021 |
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/25/2021 |
| Initial Report FDA Received Date | 01/28/2022 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| 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 |