Brand Name | DELTEC® GRIPPER PLUS |
Type of Device | SET, ADMINISTRATION, INTRAVASCULAR |
Manufacturer (Section D) |
SMITHS MEDICAL ASD; INC. |
6000 nathan lane n |
minneapolis, MN 55442 |
|
Manufacturer (Section G) |
SMITHS MEDICAL ASD; INC. |
6000 nathan lane n |
|
minneapolis, MN 55442 |
|
Manufacturer Contact |
dave
halverson
|
6000 nathan lane n |
minneapolis,, MN 55442
|
7633833310
|
|
MDR Report Key | 9235429 |
MDR Text Key | 163745437 |
Report Number | 3012307300-2019-05917 |
Device Sequence Number | 1 |
Product Code |
FPA
|
UDI-Device Identifier | 10610586033056 |
UDI-Public | 10610586033056 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K072657 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
user facility |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
10/24/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 08/16/2024 |
Device Catalogue Number | 21-3466-24 |
Device Lot Number | 3854215 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
10/08/2019 |
Initial Date FDA Received | 10/24/2019 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 08/24/2019 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|