Manufacturer (Section G) |
Young Innovations |
4321 goshen road |
|
fort wayne IN 46818 |
|
Manufacturer Contact |
tammy
shiffler
|
4321 goshen road |
fort wayne, IN 46818
|
8006542027
|
|
MDR Report Key | 8086038 |
Report Number | COR18001787-000 |
Device Sequence Number | 1 |
Product Code |
EHD
|
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
11/19/2018 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Was Device Available for Evaluation? |
No Information
|
Initial Date Manufacturer Received |
Not provided |
Initial Date FDA Received | 11/19/2018 |
Patient Sequence Number | 1 |
|
|