Brand Name | TRAY SPN SPT24G3.5 B/L/E |
Type of Device | ANESTHESIA CONDUCTION KIT |
Manufacturer (Section D) |
CAREFUSION, INC |
400 east foster rd |
mannford OK 74044 |
|
Manufacturer (Section G) |
CAREFUSION, INC |
400 east foster rd |
|
mannford OK 74044 |
|
Manufacturer Contact |
brett
wilko
|
9450 south state street |
sandy, UT 84070
|
8015652341
|
|
MDR Report Key | 8388227 |
MDR Text Key | 138109069 |
Report Number | 1625685-2019-00014 |
Device Sequence Number | 1 |
Product Code |
CAZ
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | DISCRETION |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
health professional,other,use |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
03/19/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/04/2019 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Catalogue Number | 405707 |
Device Lot Number | 0001248934 |
Was Device Available for Evaluation? |
No Answer Provided
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
|
Event Location |
No Information
|
Date Manufacturer Received | 02/13/2019 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 07/10/2018 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|