Brand Name | LP-20-120 |
Type of Device | LP-20-120 |
Manufacturer (Section D) |
COOPERSURGICAL, INC. |
75 corporate drive |
trumbull CT 06611 |
|
Manufacturer (Section G) |
COOPERSURGICAL, INC. |
75 corporate drive |
|
trumbull CT 06611 |
|
Manufacturer Contact |
peter
niziolek
|
75 corporate drive |
trumbull, CT 06611
|
|
MDR Report Key | 7968787 |
MDR Text Key | 123950309 |
Report Number | 1216677-2018-00060 |
Device Sequence Number | 1 |
Product Code |
HGI
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K963653 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,user faci |
Reporter Occupation |
|
Type of Report
| Initial |
Report Date |
10/16/2018 |
1 Device was Involved in the Event |
|
0 Patients were Involved in the Event: |
|
Date FDA Received | 10/16/2018 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
|
Device Model Number | LP-20-120 |
Device Catalogue Number | LP-20-120 |
Device Lot Number | N/A |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 08/27/2018 |
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
|
Event Location |
No Information
|
Date Manufacturer Received | 08/27/2018 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 11/07/2016 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unkown
|
|
|