Brand Name | NIPRO CELLENTIA-H DIALYZER |
Type of Device | DIALYZER |
Manufacturer (Section D) |
NIPRO CORPORATION (ODT) |
8-7, hanuki-yachi, niida-aza |
ohdate-shi, akita 018-5 794 |
JA 018-5794 |
|
Manufacturer (Section G) |
NIPRO CORPORATION (ODT) |
8-7, hanuki-yachi, niida-aza |
|
ohdate-shi, akita 018-5 794 |
JA
018-5794
|
|
Manufacturer Contact |
michelle
tejada
|
3150 nw 107th avenue |
miami, FL 33172
|
3055997174
|
|
MDR Report Key | 15431374 |
MDR Text Key | 300031846 |
Report Number | 9610987-2022-00007 |
Device Sequence Number | 1 |
Product Code |
KDI
|
UDI-Device Identifier | 00383790004398 |
UDI-Public | 00383790004398 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K160444 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
User Facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
10/04/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 09/15/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | DD+CT17H |
Device Catalogue Number | DD+CT17H |
Device Lot Number | 22A20D |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 09/13/2022 |
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 08/25/2022 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 01/20/2022 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
|
|