| Brand Name | BIOZORB |
| Common Device Name | MARKER, RADIOGRAPHIC, IMPLANTABLE |
| Manufacturer (Section D) |
| HOLOGIC, INC. |
| 250 campus drive |
| marlborough, MA 01752 |
|
| Manufacturer (Section G) |
| HOLOGIC, INC. |
| 250 campus drive |
|
| marlborough, MA 01752 |
|
| Manufacturer Contact |
|
daniel
guevara
|
| coyol free zone building b24 |
| alajuela |
| alajuela, 20102- CRI
|
|
CS
20102 CRI
|
|
| MDR Report Key | 21159833 |
| Report Number | 1222780-2025-01014 |
| Device Sequence Number | 7631584 |
| Product Code |
NEU
|
| UDI-Device Identifier | 00851766006085 |
| UDI-Public | (01)00851766006085(17)160930(241)F0331(10)K1-151006 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NV |
| Initial Reporter Country | US |
| PMA/510(K) Number | K152070 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2016 |
| Device Explanted Year | 2016 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer,Health Professional,User Facility |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
01/15/2025 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
No
|
| Device Expiration Date | 09/30/2016 |
| Device Model Number | F0331 |
| Device Catalogue Number | F0331 |
| Device Lot Number | K1-151006 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/06/2016 |
| Initial Report FDA Received Date | 01/15/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 10/06/2015 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
Hospitalization;
|
| Patient Age | 49 YR |
| Patient Sex | Female |
|
|