| Manufacturer (Section D) |
| CONMED |
| 525 french rd |
| utica NY 13502 |
|
| Manufacturer (Section G) |
| CONSOLIDATED MEDICAL EQUIPMENT COMPANY |
| ave. alejandro dumas 11321 |
| complejo industrial chihuahua |
| chihuahua 31136 |
|
MX
31136
|
|
| Manufacturer Contact |
|
robin
drum
|
| 525 french rd |
| utica, NY 13502
|
|
8653881978
|
|
| MDR Report Key | 25777499 |
| Report Number | 3007305485-2026-00143 |
| Device Sequence Number | 9625766 |
| Product Code |
---
|
| UDI-Device Identifier | 10845854045640 |
| UDI-Public | (01)10845854045640(17)290114(10)2026011510 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CO |
| Initial Reporter Country | US |
| PMA/510(K) Number | K230239 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/29/2026 |
| 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? |
Yes
|
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | Not provided |
| Supplement Date Received by Manufacturer | 07/16/2026
|
| Initial Report FDA Received Date | 07/10/2026 |
| Supplement Report FDA Received Date | 07/29/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Patient Age | 21 YR |
| Patient Sex | Female |