Brand Name | DUODERM/GRANUFLEX/DUOACTIVE - MOISTURE RETENTIVE DUODERM CGF DRESSING |
Type of Device | DRESSING,WOUND,OCCLUSIVE |
Manufacturer (Section D) |
CONVATEC DOMINICAN REPUBLIC INC |
km 18.5 parque industrial |
itabo, s.a. haina |
san cristobal |
|
Manufacturer (Section G) |
CONVATEC DOMINICAN REPUBLIC INC |
km 18.5 parque industrial |
itabo, s.a. haina |
san cristobal |
|
Manufacturer Contact |
jeanette
johnson
|
7900 triad center drive |
suite 400 |
greensboro, NC 27409
|
3365424681
|
|
MDR Report Key | 9129497 |
MDR Text Key | 160560528 |
Report Number | 9618003-2019-05473 |
Device Sequence Number | 1 |
Product Code |
NAD
|
Combination Product (y/n) | N |
PMA/PMN Number | EXEMPT |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
distributor,foreign |
Reporter Occupation |
Other
|
Type of Report
| Initial |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
No
|
Device Operator |
Other
|
Device Expiration Date | 05/01/2024 |
Device Model Number | 187957 |
Device Lot Number | 9E00834 |
Was Device Available for Evaluation? |
No
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
09/26/2019 |
Initial Date FDA Received | 09/27/2019 |
Was Device Evaluated by Manufacturer? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|