Brand Name | XCEL DILATING TIP TROCAR 11MM |
Type of Device | LAPAROSCOPE, GENERAL AND PLASTIC SURGERY |
Manufacturer (Section D) |
ETHICON ENDO-SURGERY, LLC. |
475 calle c |
guaynabo 00969 |
|
Manufacturer (Section G) |
ETHICON ENDO-SURGERY, LLC. |
475 calle c |
|
guaynabo 00969 |
|
Manufacturer Contact |
kara
ditty-bovard
|
475 calle c |
guaynabo 00969
|
6107428552
|
|
MDR Report Key | 9547581 |
MDR Text Key | 188495500 |
Report Number | 3005075853-2020-00063 |
Device Sequence Number | 1 |
Product Code |
GCJ
|
UDI-Device Identifier | 10705036001560 |
UDI-Public | 10705036001560 |
Combination Product (y/n) | N |
Reporter Country Code | BR |
PMA/PMN Number | K032676 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,health professional |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
12/09/2019 |
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? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 02/29/2024 |
Device Catalogue Number | D11LT |
Device Lot Number | T4097R |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
12/09/2019 |
Initial Date FDA Received | 01/03/2020 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 04/03/2019 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |