Brand Name | OXYGENATOR, CARDIOPULMONARY BYPASS |
Type of Device | OXYGENATOR, CARDIOPULMONARY BYPASS |
Manufacturer (Section D) |
MAQUET CARDIOPULMONARY GMBH |
neue rottenburger strasse 37 |
hechingen |
|
Manufacturer (Section G) |
NURSEL BOELENS |
maquet cardiopulmonary ag |
kehler strasse 31 |
rastatt 76437 |
GM
76437
|
|
Manufacturer Contact |
|
maquet cardiopulmonary ag |
kehler strasse 31 |
rastatt 76437
|
4972229321
|
|
MDR Report Key | 8878389 |
MDR Text Key | 163737733 |
Report Number | 8010762-2019-00239 |
Device Sequence Number | 1 |
Product Code |
DTZ
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
PMA/PMN Number | K082117 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer,foreign,health profe |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
08/08/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 08/09/2019 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 10/20/2020 |
Device Model Number | HMO 71000 #SQUADROX-I ADULT + FILTER |
Device Catalogue Number | 701067821 |
Device Lot Number | 70127550 |
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 07/25/2019 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 10/21/2018 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |