Brand Name | DISPOSABLE PNEUMATIC VITRECTOME, 25 GAUGE |
Type of Device | DISPOSABLE PNEUMATIC VITRECTOME, 25 GAUGE |
Manufacturer (Section D) |
DUTCH OPTHALMIC RESEARCH CENTER BV |
scheijdelveweg 2 |
zuidland, 3214V N |
NL 3214VN |
|
Manufacturer (Section G) |
DUTCH OPTHALMIC RESEARCH CENTER BV |
scheijdelveweg 2 |
|
zuidland, 3214V N |
NL
3214VN
|
|
Manufacturer Contact |
laura
smith
|
10 continental dr |
bldg 1 |
exeter, NH 03833
|
6037786929
|
|
MDR Report Key | 7621916 |
MDR Text Key | 112449715 |
Report Number | 1222074-2018-00194 |
Device Sequence Number | 1 |
Product Code |
HQC
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign |
Reporter Occupation |
Medical Equipment Company Technician/Representative
|
Type of Report
| Initial |
Report Date |
08/25/2016 |
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 |
Physician
|
Device Catalogue Number | 6268.NMD05 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
No
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
08/25/2018 |
Initial Date FDA Received | 06/20/2018 |
Was Device Evaluated by Manufacturer? |
Yes
|
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 |
|
|