Brand Name | CADD® MEDICATION CASSETTE RESERVOIR |
Type of Device | SET, ADMINISTRATION, INTRAVASCULAR |
Manufacturer (Section D) |
SMITHS MEDICAL ASD, INC. |
6000 nathan lane north |
minneapolis MN 55442 |
|
Manufacturer (Section G) |
SMITHS MEDICAL ASD, INC |
1265 grey fox rd |
|
st. paul MN 55112 |
|
Manufacturer Contact |
dave
halverson
|
6000 nathan lane n |
minneapolis, MN 55442
|
7633833310
|
|
MDR Report Key | 7456893 |
MDR Text Key | 106407143 |
Report Number | 3012307300-2018-00993 |
Device Sequence Number | 1 |
Product Code |
FPA
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer |
Type of Report
| Initial |
Report Date |
04/20/2018 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 04/24/2018 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Patient Family Member or Friend
|
Device Model Number | 6400 |
Was the Report Sent to FDA? |
No
|
Date Manufacturer Received | 04/02/2018 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Removal/Correction Number | MW5075863 |
Patient Sequence Number | 1 |