| Brand Name | SafeSheath® II |
| Common Device Name | INTRODUCER, CATHETER |
| Manufacturer (Section D) |
| Oscor Inc. |
| 4875 palm harbor blvd. |
| palm harbor FL 34683 |
|
| Manufacturer (Section G) |
| Oscor Inc. |
| 4875 palm harbor blvd. |
|
| palm harbor FL 34683 |
|
| Manufacturer Contact |
|
mohit
malkani
|
| 4875 palm harbor blvd. |
| palm harbor, FL 34683
|
|
+1(727)937-2511
|
|
| MDR Report Key | 50430788 |
| Report Number | 1035166-2026-00069 |
| Device Sequence Number | 10422981 |
| Product Code |
DYB
|
| UDI-Device Identifier | 30891492002259 |
| UDI-Public | 30891492002259 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | K122084 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Distributor |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/25/2026 |
| 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 | SS9 |
| Device Catalogue Number | SS9 |
| Device Lot Number | S10445125 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Initial Date Received by Manufacturer | 07/29/2026 |
| Initial Report FDA Received Date | 08/25/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 01/28/2026 |
| 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 |
| Patient Sex | Unknown |
|
|