| Brand Name | McGRATH |
| Common Device Name | LARYNGOSCOPE, RIGID |
| Manufacturer (Section D) |
| MEDTRONIC SOFAMOR DANEK USA, INC |
| 4340 swinnea road |
| memphis,tn |
|
| Manufacturer (Section G) |
| MEDTRONIC SOFAMOR DANEK USA, INC |
| 4340 swinnea road |
|
| memphis,tn |
|
| Manufacturer Contact |
|
mike
bocchino
|
| 8200 coral sea st ne |
| mounds view, MN 55112--439
|
|
+1(800)646-4633
|
|
| MDR Report Key | 50849118 |
| Report Number | 3003120897-2026-01594 |
| Device Sequence Number | 21209372 |
| Product Code |
CCW
|
| UDI-Device Identifier | 10884521824157 |
| UDI-Public | (01)10884521824157(17)270115(10)H24110904 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Foreign,Distributor |
| Type of Report
| Initial |
| Report Date (Section B) |
09/21/2026 |
| 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 | 340-000-000 |
| Device Catalogue Number | 340-000-000 |
| Device Lot Number | H24110904 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 08/28/2026 |
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/26/2026 |
| Initial Report FDA Received Date | 09/21/2026 |
| Date Device Manufactured | 01/15/2025 |
| 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
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|