Brand Name | ESP¿ |
Type of Device | GLOVE, PATIENT EXAMINATION, SPECIALTY |
Manufacturer (Section D) |
BOSTON SCIENTIFIC - COSTA RICA (COYOL) |
2546 first street |
propark free zone |
alajuela |
CS |
|
Manufacturer (Section G) |
BOSTON SCIENTIFIC - COSTA RICA (COYOL) |
2546 first street |
propark free zone |
alajuela |
CS
|
|
Manufacturer Contact |
sonali
arangil
|
one scimed place |
maple grove, MN 55311
|
7634941700
|
|
MDR Report Key | 7487016 |
MDR Text Key | 107352499 |
Report Number | 3005099803-2018-01294 |
Device Sequence Number | 1 |
Product Code |
LZC
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K891968 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
04/11/2018 |
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
|
Device Operator |
Health Professional
|
Device Model Number | M0067051041 |
Device Catalogue Number | 705-104 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
04/11/2018 |
Initial Date FDA Received | 05/04/2018 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |