Brand Name | ALPHASTAR MOBILE OPERATING TABLE |
Type of Device | TABLE, OPERATING-ROOM, AC-POWERED |
Manufacturer (Section D) |
HOLGER ULLRICH |
maquet gmbh |
kehler strasse 31, |
rastatt 76437 |
GM 76437 |
|
Manufacturer (Section G) |
HOLGER ULLRICH |
maquet gmbh |
kehler strasse 31, |
rastatt 76437 |
GM
76437
|
|
Manufacturer Contact |
|
maquet gmbh |
kehler strasse 31, |
rastatt 76437
|
|
MDR Report Key | 7909448 |
MDR Text Key | 121862049 |
Report Number | 8010652-2018-00023 |
Device Sequence Number | 1 |
Product Code |
FQO
|
Combination Product (y/n) | N |
Reporter Country Code | BR |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,health professional,u |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
09/25/2018 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 09/26/2018 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | 113201A0 |
Device Catalogue Number | 113201A0 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Device Age | YR |
Date Manufacturer Received | 08/29/2018 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 07/15/2000 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
Patient Age | 33 YR |
Patient Weight | 110 |